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How do Social Security benefits/Medicare benefits fit into the mix with long term care policies?

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BOBBY HINKLE, Long-term care insurance expert

How do Social Security benefits/Medicare benefits fit into the mix with long term care policies?

Generally speaking, people who are turning 65 or 66 right now are in full retirement, and those people already have access to full Social Security benefits. Social Security is a fairly complex subject. In most cases, someone who took their Social Security benefit early, at age 62, is getting a reduced benefit. If they file for Social Security disability, they would receive the full benefit or what they would have received at age 65 or what their full retirement age is. There is no additional benefit for long-term care costs.

What about Medicare?

Medicare pays for short term home health or hospice benefits requiring a doctor’s order.  However, Medicare does not provide any benefits for long term care coverage. Even when there is a doctor’s order involved, Medicare does not cover everything and there are a lot of exclusions.

If I’m elderly, with no close relative to look after me, how would my claims be filed each month on my behalf?

Most insurance companies will send a representative to a person’s place of residence to do an initial assessment which may or may not require review of recent medical records. Once the process has started, you will need to utilize a close family member, the in home care company providing service or a patient advocate for assistance with filing claims. Direct billing can be set up with the insurance company. This can be something that is specific to the insurance company, so it is important to be familiar with your policy.

(Bobby Hinkle is owner of Main Street Advisors, an Oklahoma City-based independent insurance agency, along with a registered investment advisory firm, Main Street Investment Management.  Bobby recently took time to answer questions about long-term care insurance for SYNERGY blog readers.)


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