Thanks for all the replies on my disability question. Our premium payment is in February, and we will think very hard about it by then.
I checked and my waiting period is 90 days. Is that good or bad?
The longer the waiting period, the lower the premiums for the same benefit. Itâs like a deductible. You choose the highest one that you can afford (you will have to assume the cost for those 90 days of your waiting period, plus whatever time before you applied and the waiting period began) before you can start collecting whatever your benefits are for the insurance.
We tend to get the highest deductibles we can afford for most insurance, except our medical which has NO deductibe (itâs an excellent group plan provided by Hâs former employer).
My disability had a 60 day waiting period, while my LTC ins has 90 days (CNA only sold with 90 day waiting period).
Not sure how much age bumps up LTC insurance now, but the premiums are generally pretty steep for the coverage that I have read in Money or Kiplinger articles. If we didnât have our policies, we would have to do the default self insure option and hope for the best.
My SIL tells me the standard waiting period for LTC is 90 days because Medicare covers 90 days in a nursing home following a hospital admission. Those who fit that profile wonât financially suffer much, but if you go into LTC care from home instead of a hospital; or if youâre not Medicare-eligible, youâll pay the full amount until youâve hit the number of days youâre responsible for.
Isnât a big problem that hospitals are now not actually âadmittingâ people for the three day overnight stay period that is required? They will bring them in for observation, and do the same stuff they would in any other case, but they arenât officially admitting them. Apparently it works against their statistics, if the person has to return to the hospital. And Medicare will not cover the time in a rehab facility or nursing home, unless they are officially admitted. That is, if I got the story straight.
In MILâs experience: Medicare coverage was for skilled nursing care after surgery, which was part of Medicareâs hospitalization coverage (IIRC). But continued coverage was contingent on ongoing certification that SNC was required, which required periodic evaluations.
https://www.medicare.gov/Pubs/pdf/10153.pdf
There is a very good possibility that Medicareâs coverage will not smoothly get one to LTC insurance coverage (which requires another threshold of certification).
I have a one year waiting period for my disability policy because I have enough leave time to be out a year.
My policy is cheap.
Yes, it is a huge problem that folks are unaware ofâhospitals ARE having patients âfor observationâ instead of admitting them so they donât get penalized and so their stats are better. If they are not HOSPITALIZED for 3 days immediately prior to being discharged to a skilled nursing facility of nursing home, they are NOT covered by Medicare and most insurance. Itâs VERY important to clarify whether you/loved one is ADMITTED to the hospital or âunder observation.â If they may need additional care after leaving the hospital, itâs CRUCIAL they are hospitalized for AT LEAST 3 days.
I think I have 6 months deductible on my disability policy.
This topic came up on the Parents caring for parents thread, and one very good piece of advice was to contact the assigned case manager and lobby assertively for hospital admission and 3 day stay. I hadnât realized how much decision making power these staff members have. Doctors are usually willing to consider the familys wishes too, so itâs important to speak up and tell them what you want rather than just waiting in limbo.
That sounds like very important advice, momsquad. Sad that it has to be insider information, only. If you know this information, you get covered, if you donât-you could be in trouble. It seems like a very unfair numbers game.
Yes, it is indeed unfair and VERY expensive for the unwary! Many ASSUME that if their loved one was in the hospital for 3 days, they were âhospitalizedâ and therefore that they would be covered by Medicare and/or their insurance if they need skilled nursing facility upon discharge. They only find out their expensive mistake AFTER expenses mount AFTER the loved one is out of the hospital and was only âunder observation.â
That is absolutely crazy, HImom. Who really checks whether their loved one is actually âadmittedâ or not. And what if they refuse to admit you, but insist that you are only there for observation? I guess itâs the law of unintended consequences.
I think itâs the case of the squeaky wheel getting the grease. You have to insist that your loved one be admitted and indicate that they will need care upon discharge to be rehabilitated. If you donât say anything, youâre at the mercy of the bureaucrats. Itâs wrong, but itâs how things are currently.
@HImom, is that with 2 insurances or just Medicare ?
Iâm not positive, but insurers tend to follow whatever Medicare does, so it may well be both insurers AND Medicare, but check it out for yourself.
Cause if Medicare doesnât cover then the second insurance should kick in right?
If both donât cover, no, then the patient is out of luck. Insurers only cover specifically what the terms of the poicy state. They are not required to cover more than statute (ACA) and their terms specify. There are MANY things that are not covered by Medicare and also not covered by insurance. Thatâs just how things are.
Often insurers only cover whatever Medicare covers and when Medicare stops covering something, the insurers do as well.
Thatâs crazy, I never thought that would be the case with 2 insurances. Whatâs the point of having 2 insurances then?