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This is so true. I know someone whose mother was moved from assisted living to the nursing home section of the facility where she was living.
The LTCI refused to pay as there was a clause stating that to qualify for payment she must be discharged directly from a hospital to the nursing home.
Because the facility moved her directly from assisted living to the nursing home, insurance would not pay.
you have the story wrong , this is how myths perpetuate.
that is not the correct story because it was not a long term care policy they were trying to get to pay .
they were trying to get medicare to cover the up to 100 days in a nursing home that they will cover under certain conditions . one of which is you have a limited time to go from hospital to nursing home
“ In order for a nursing home stay to be covered by Medicare, you have to meet the following requirements:
You must enter the nursing home no more than 30 days after a hospital stay (meaning admission as an inpatient; "observation status" does not count) that itself lasted for at least three days (not counting the day of discharge).”
Last edited by mathjak107; 11-28-2021 at 03:53 PM..
i bet that is not the correct story because it was not a long term care policy they were trying to get to pay .
they were trying to get medicare to cover the up to 100 days in a nursing home that they will cover under certain conditions . one of which is you have a limited time to go from hospital to nursing home
“ In order for a nursing home stay to be covered by Medicare, you have to meet the following requirements:
You must enter the nursing home no more than 30 days after a hospital stay (meaning admission as an inpatient; "observation status" does not count) that itself lasted for at least three days (not counting the day of discharge).”
yes - when my mom first went to a nursing home, she had to have stayed 3 nights in the hospital for Medicare to cover the first 20 days - and that could be moved to 30.
yes - when my mom first went to a nursing home, she had to have stayed 3 nights in the hospital for Medicare to cover the first 20 days - and that could be moved to 30.
exactly ..
that malarkey below they tried to tell us about a long term care policy not paying was not the case ….they were trying to get medicare to cover the nursing home stay.
what transpired is what happens when you miss the allowed time frame for medicare covering the nursing home stay for the allowable days after you get out of the hospital.
that has zero to do with a long term care policy not paying, obviously they did not have a long term care policy.
a typical case of what we think we know aint so .
Quote:
Originally Posted by Nefret
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This is so true. I know someone whose mother was moved from assisted living to the nursing home section of the facility where she was living.
The LTCI refused to pay as there was a clause stating that to qualify for payment she must be discharged directly from a hospital to the nursing home.
Because the facility moved her directly from assisted living to the nursing home, insurance would not pay.
I am similar in that I don't go running to doctors for every sniffle or ache. I too have managed to avoid doctors for the most part. Had a life-threatening thyroid condition so rare there was a paper written about it, but that's been resolved with no recurrence eight years later. I know there's no guarantee I'll dodge every bullet, but even today, I went for a COVID test (for travel purposes) and my BP was OK, oxygen saturation 99%, temp OK, etc. I am 63. However, I've got someone close to me who looked healthy and hearty six months ago and now cannot walk, use his hands, or speak clearly. Came on out of nowhere, a rare neurological condition. His family is trying to figure out what his long-term care plan will be.
One suggestion, no matter what, is that people might want to look at their homes and ask themselves whether the house would be livable should mobility become limited. A paramedic I was talking to recently, a man in his 30s, said he has seen enough that when he had his house built, he made sure he had wide doorways and hallways, limited stairs, etc. A split-level where you have to go up or down three or four steps to get to a kitchen or bathroom is not a good place to be. Long narrow hallways that don't accommodate wheelchairs are not helpful.
Of course, people can have a sudden health change and you should be as prepared as possible to deal with it. Wife and I are seemingly very healthy and can take care of the other if need be. If we need long-term care, we can get it, it just would lower the inheritance of our children. We're both on the younger half of our 60's.
Our current house is a 2 story and we have looked at getting a lift for my wife who has knee problems so that's one way to deal with that situation and we have the ability to buy a 1 story and will probably have to do that at some point.
you have the story wrong , this is how myths perpetuate.
that is not the correct story because it was not a long term care policy they were trying to get to pay .
they were trying to get medicare to cover the up to 100 days in a nursing home that they will cover under certain conditions . one of which is you have a limited time to go from hospital to nursing home
“ In order for a nursing home stay to be covered by Medicare, you have to meet the following requirements:
You must enter the nursing home no more than 30 days after a hospital stay (meaning admission as an inpatient; "observation status" does not count) that itself lasted for at least three days (not counting the day of discharge).”
I am well aware of the Medicare requirements for a 100 day stay in a nursing home.
The daughter who told me this story may have gotten the facts wrong. However, I can see where a medical evaluation would be required to determine that the person did indeed require nursing home care vs. assisted living which was not covered by the LTCI.
Really folks............. Long-Term Insurance doesn't work because it is so EXPENSIVE. Insurance company will go broke, and there goes your long-term care.
And the Government, well they want you to spend ALL YOUR money, and then they will pay for long-term care. GOT KIDS?? Make them a offer....long-term care for their inheritance.
BUT THEN....we as a country went through this before....the Civil War brides. Yep, the last Civil War bride's pension was paid in the 1990???
So this is my plan....My wife or I need long-term care the other provides.
My wife dies first....I put an ad in the local paper for a long-term care giver. Full room and board, but no salary. However, she can have the survivor benefit from my pension. A pension for the rest of her lifetime, and INDEXED for inflation.
If I can find somebody young enough she will have that pension into the 22nd century!!
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I tend to be more proactive than reactive.
