Last week, I talked about cash and reimbursement policies. A few people took exception to a couple of the points that I made which prompted this week’s FWF.
Pertaining to cash benefits, the point that I am attempting to make is that there is an extra level of responsibility that comes with access to the cash. The responsibility is not something that can be ignored as it can (and will) impact the insured (care recipient).
“You are being biased again Fisher,” someone will say.
As I explained last week (maybe poorly), there is a little more accounting that takes place at tax time along with that is the need to be aware of where the monies flow particularly when the monthly check exceeds monthly expenses. This may, at tax time, require documentation (receipts) to validate that the cash benefits received are for long-term care support & services.
Like I said last week, the responsibility lies with the insured, their family, and whomever is managing their affairs.
Another point that I want to make is that regardless of which policy is utilized, the same qualifying criteria needs to be met. The insured must be either unable to perform 2 of 6 activities of daily living (bathing, continence, dressing, eating, transferring, toileting) or have a severe cognitive impairment. A plan of care will also be necessary.
For more on how to file a claim at OneAmerica Financial, check this out.
(Note: one of the most common reasons for a claim being declined is that a plan of care is not submitted.)
Once that claim is approved and the elimination period is met, benefits can begin to be paid.
Here is where things go sideways in the conversation … cash gives you control and freedom while a reimbursement benefit is more restrictive. Frankly this is a half-truth!
For informal care, cash is the best solution. The cash benefit with formal care, while providing maximum cash, will require whomever is managing the affairs of the insured to receive a bill, pay a bill, deposit a check, along with handling the care decisions.
When formal care is received and a reimbursement benefit is in place, the policy can directly pay care providers just like a health insurance policy would. The stigma that cash advocates have is that you have to receive the bill, submit the bill, pay the bill, then deposit the check.
“Hold on Fisher! You are repeating yourself!”
No, I am not … the process is the same regardless of being cash or reimbursement. What it comes down to how “hands on” the person who is responsible for the insured’s affairs will be in the claims paying process.
You see – it is no more nor less intrusive to have a reimbursement plan. As I have said before, each plan has its own strengths.
And, regardless of how the benefits are paid, there needs to be a plan in place that is communicated by the insured (care recipient / client) to their family. And, the family needs to understand and accept the responsibilities that are being thrust upon them. This is where most plans fall apart.
They are not communicated and accepted by the family.
Develop a plan – communicate that plan – fund that plan … it’s that simple.
For more information about Asset Care 2024 or claims, you can contact my internal Kelley Hilliard directly at (844) 623-4251 or via email at kelleyhilliard.isp@oneamerica.com
Fridays with Fisher 