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Q: What can a person expect when they make a claim for long term care benefits? A: When you make a long term care insurance claim, you can expect a face-to-face assessment of your condition, typically conducted by a nurse. Here’s a common scenario: You or someone acting on your behalf, call the insurance company to initiate the claim process. An adjudicator then calls back and conducts a pre-screening telephone interview to determine if it’s likely you have a condition that would make you eligible for benefits. If so, the adjudicator arranges for an assessment in your home to confirm eligibility for benefits and to determine if you need help accessing care. Normally, periodic updates of your condition are required while you’re on claim. Here’s a tip. Did you know that long term care insurance claims experience has shown that in most cases it’s the child of a policy owner who will ultimately be the insurance company’s contact for the claim – even if the spouse or other authority has power of attorney. That’s why it’s important to make sure your child, or children, knows about your policy. If they have an understanding of what the policy covers and how the claim process works, it will go more smoothly.
Q: How important is a living will in a long term care situation? A: A power of attorney for personal care (often referred to as a living will) is a useful tool that helps family members deal with difficult decisions regarding a loved one’s health care. The primary reason you would want to sign a power of attorney document for personal care is to convey specific instructions about medical procedures that you don’t want performed or to provide a general statement as to your philosophy on care. The document can be very specific as to what kind of medical procedures may be done and what type of care is to be provided. If a power of attorney for personal care is not signed while you have capacity, upon loss of capacity, either an interested individual must obtain a court order to be appointed as your guardian or the Public Guardian and Trustee must be involved to obtain authority to act for you. If capacity is in issue, an authorized medical assessor must be involved to determine whether you are truly incapacitated. As a result, delays and expense in obtaining this authority are inevitable where no document exists. Having a power of attorney document for personal care in place helps minimize future expenses, uncertainty and stress for family members and preserves to some extent the incapable person’s ability to control the treatment he or she receives when they are no longer able to make a decision. Note: This article is based on the law of Ontario. Provincial law dealing with this issue may vary.
Q: I’m a boomer. How will my care needs in older age be different from my parents’? A: The makeup of boomers’ families is unique to any previous generation. We have fewer kids, experience more divorce, and our adult children migrate more frequently from city to city. This means we can’t rely on family as primary caregivers to the same degree our parents have. Life expectancy is also increasing, so if you’re lucky enough to live to age 85, there’s a strong likelihood you will require long term care. Q: Is it true that elderly women face more hardships? A: It’s certainly true in terms of long term care. Women often spend their lives as caregivers, but when they need old age care, there may be no one to turn to. Women tend to outlive their spouses, or their male counterparts feel uncomfortable in the primary caregiver role. Consequently, elderly women often need to seek outside help for long term care. In advanced age, a woman may face retirement savings short-falls, especially if significant dollars were spent years earlier to support their partner’s long term care needs. All these factors signal the need for women to be very proactive in planning for their own long term care, as early as possible.
Q: Why is long term care planning so relevant now? A: Most Canadians mistakenly believe that the government will care for us in old age. But our rapidly aging population suggests we have a false sense of security. Statistics Canada projects that by 2021, Canada’s seven million Canadian seniors will represent 19 per cent of our total population. The surging population of seniors will surely require more health-related services, including long term care – both in home and in long term care facilities. The demand will be huge and health care costs will escalate. Who’s going to pay for all this? Instead of putting their heads in the sand, people need to take some responsibility now, while they are healthy. The financial impact on many families could be devastating. Q: What should I consider in planning for my long term care needs? A: Long term care insurance is a great solution. It’s really part of a defensive asset protection strategy. The choice is simple: you can pay for long term care in the future by drawing down and depleting your investments (and potentially your children’s) or you can purchase long term care insurance now and let the insurance company carry the financial risk. As an example, today’s cost of private care can easily exceed $5,000 per month. That’s more than $60,000 per year after tax. Now imagine the impact of being sick for many years. How many people can shoulder that kind of financial hit? Getting a retirement plan in place that includes long term care insurance simply makes good financial sense. Back to Top | |||||||||||||||
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