BrightStar Care of Baltimore City/County is Accepted by all
Long Term Care Insurance Companies
BrightStar Care of Baltimore City/County is accepted or considered “in network” with all Long-Term Care Insurance providers.
Long term care benefits can pay for in-home assistance with activities of daily living, (ADLs), including:
- Incontinence care
- Assistance with transfers
- Meal preparation
- Light housekeeping
- Medication reminders
BrightStar Care can provide this care to clients in the comfort of their own home.
Long Term Care Insurance (LTCI) is not part of Medicare or a Medicare Insurance Supplemental Plan.
LTCI is similar to a life insurance policy. Once you purchase it, there is an annual premium. Most individuals with LTCI have purchased it through a life insurance Agent or a financial planner. Former employees of Baltimore City, Baltimore County, and the Baltimore School District had the opportunity to purchase Long Term Care Insurance as part of their benefits plan.
Each year, LTCI holders lose out on benefits from long term care policies because they simply do not remember they have them or do not know how to apply for benefits properly.
Insurance company employees do not always know how to provide helpful tips related to properly filing a claim and/or ways to eliminate or reduce the policy deductible or elimination, (self-pay) periods.
BrightStar can provide tips that may result in significant monetary savings for policyholders and can increase the likelihood that claims are approved and approved in a timely manner.
Here are some things to look for when interpreting your policy:
- Understand what the critical triggers are that increase the likelihood that the claim will be approved. Is dementia a trigger or assistance with 3 ADL?
- Is the benefit written as a daily, weekly, or monthly amount? Understand the difference and how to best use the policy.
- Find out if other services that are paid for by Medicare can be used towards the elimination period. In many cases, the answer is “yes”.
- Recognize that if once you start using your policy, you may be able to stop paying the annual premium. This is called “waiver of premium”.
- Understand that using the right home care company, one that understands long term care insurance, is critical to helping get claims paid and validate the benefits. At BrightStar Healthcare of Baltimore City/County, we are long term care insurance experts and can help you get your claim approved and paid.
BrightStar Care of Baltimore City/County is accepted by ALL LTCI providers.
- We only use employees, we do not use sub-contractors.
- We have full-time RNs on staff that develop the plan of care and supervise our staff.
- We have Joint Commission Accreditation and Maryland state licensure at the level of RSA 3.
These are the qualities insurance companies want to see in a home care agency.
Are you interested in purchasing Long Term Care Insurance for yourself? You can purchase this from a financial advisor or insurance agent but they may sell you the product that is from the company they represent and may not be your best option.
I refer to Melissa Barnickel of Bay Group Insurance, who consults with you regarding your needs and then finds the best product in the market that meets your needs.
IF you have a policy and want to file a claim or ask questions about an existing policy
COMPANY PHONE FAX WEB
|American Heritage Life Ins
|Bankers Life & Casualty Co.
|Prudential Ins. Of America
|State Farm Insurance
Understanding your policy
After locating your policy and identifying the policy number, you will want to call the insurance company’s claims department. You should ask the following questions if you have not identified them in your policy:
What is my elimination period?
This is the amount of time after filing a claim that you will be responsible for out-of-pocket care expenses before the benefits of the policy will start to assume all or a portion of those expenses
What is the amount of my daily benefit for private care? Is it weekly cumulative?
This the amount your policy will reimburse you daily on services for the policy owner. Most policies have an established daily benefit amount, but some policies will allow you to roll your daily benefits into a 7 day/weekly cumulative benefit total. If you need less service one day and more another day, it does not matter as long as you do not go over the daily benefit x 7 (example: A daily benefit of $150 will allow for total services of $1050 for the week regardless of which days the services are delivered).
Do you have a form I can complete and fax or email to you so that the care company can send you documentation directly and communicate with you regarding my policy?
Some companies have a release of information document that allows a third party to speak with them about the details of the policy. This can be valuable if the EOB (Explanation of Benefits) that is sent to you is not showing coverage for all services submitted for reimbursement. This allows us to quickly identify if there is more documentation needed, time revisions, or some other correction needed for full reimbursement.
Upon calling the claims department, you will need to formally file a claim. This will begin the process with the insurance company. They will ask some questions and may also need to retrieve some information and documentation from the policy owner’s doctor. Additionally, they will be move to have an assessment completed by their nurse to qualify your loved one for the benefit. When this nurse comes, it is not the time to be strong or overly vague. You want to detail what you need help with and the true reality of your situation so they accurately assess the validity of the claim.
Once the nurse has completed the assessment, the claims department will contact you. BrightStar will be able to move forward, with the approved claim number, to provide services and send all needed documentation to your insurance company for your personal reimbursement. Because you are the claimant on the policy, the insurance company will send reimbursement checks to you directly…not to BrightStar.
Key Questions about Long Term Care Insurance
To help you understand your long term care insurance policy, BrightStar Care Baltimore City/County offers these key questions that you should know the answers to:
1. What is the elimination period of my policy (out-of-pocket expense)?
Is it calendar days or days of paid care? (How many hours/days are needed to complete the elimination period?
Does it need to be consecutive days or can there be a three month break with no services?
Does a hospital or rehab stay paid for by Medicare count for part of the elimination period?
If you stop care do you need to restart the elimination period? How many days? Does a hospitalization or rehab facility count?
If you are on Hospice is the elimination period waived?
2. What are the minimum number of ADL’S (activities of daily living) you must need assistance with to qualify to use your policy?
Does “dementia only” count if supervision is needed for safety? Are doctors’ orders or a diagnosis of Alzheimer's or dementia needed?
3. What is the process to activate the policy?
Does LTC insurance send their own nurse to do an assessment?
Do you need to have a contract/agreement with a homecare company to activate the policy?
4. What is the daily/weekly/monthly and lifetime maximum payout/coverage?
5. Is there an inflation rider? What is the new dollar amount?
6. Once the policy is activated does the premium stop? Does it continue during the elimination period and only stop when the insurance payment has begun? Does the premium continues?
7. What is the address for billing information and what is the insurance company’s preferred method of receiving notes and invoices? Do they require notes?
Have realistic expectations. Insurance companies will do what they can to avoid paying a claim. It is very common and expected for them to state that they did not receive you paperwork to activate the policy or the notes or invoices to trigger payment.
Are you interested in purchasing long term care insurance for yourself?
You can purchase this from a financial advisor or insurance agent but they may sell you the product that is from the company they represent and may not be your best option.I refer to Melissa Barnickel of Bay Group Insurance, who will consult with you regarding your needs – and then find the best product in the market to meet them.
Learn more about long term care insurance in Baltimore City and Baltimore County
Call BrightStar Care at (443) 275-2796