As philosopher O.N.
Bryan, Jr. would have phrased it, “she enjoyed poor health.”
She enjoyed it to the end, which
included two-and-a-half years in a long term care facility and a brief stint in
hospice. While she expressed her consternation over care with great gusto and
frequency to her children, the care she received was top notch and the staff
was caring and responsive. They adored her.
Thanks to a long term care
insurance policy, she was able to enjoy her poor health while keeping the
wolves away from the door. With residential care costing as much as $6,000 a
month, the long term care policy enabled her to at least maintain peace of mind
concerning her financial health.
She was my mother-in-law.
From the introspection which
followed her passing, my wife and I determined to pursue long term care
insurance for ourselves, while we are both young enough and healthy enough to
receive a good rate. There is no dearth of information available on long term
policies, and the National Association of Insurance Commissioners (NAIC) has
produced a good pamphlet – A Shopper’s
Guide to Long-Term Care Insurance.
In order to get a broader picture
of the scope and affordability of long term care policies, we turned to many
sources before meeting with an agent. The morning of the first meeting, it
occurred to me that the nascent Affordable Care Act might have some provisions
for long term care. Now that the healthcare.gov website has been revamped and
is supposedly working well, I went online to ask questions.
That was all. Just to ask
questions. Primarily, does or will the ACA cover long term care?
Finding the website less than
intuitive, and ineffective with a search for “long term care,” I went to the
“Live Chat” feature for help. Here is
how it went, verbatim:
ACA LIVE CHAT CONVERSATION ON LONG TERM CARE – 12/4/13
[08:49:26 am]:Thanks for
contacting Health Insurance Marketplace Live Chat. Please wait while we
connect you to someone who can help.
|
[08:49:29 am]:Please be patient
while we're helping other people.
|
[08:49:56 am]:Welcome! You're now
connected to Health Insurance Marketplace Live Chat.
Thanks for contacting us. My name is Sherry. To protect your privacy, please don't provide any personal information, like Social Security Number, or any other sensitive medical or personal information. |
[08:50:14 am]:Gordon
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Does or will the
ACA have provisions for long term care?
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[08:50:21 am]:Sherry
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Welcome to the
Health Insurance Marketplace web chat, to better assist you, may I have the
State in which you reside?
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[08:50:33 am]:Gordon
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T
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[08:50:37 am]:Gordon
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Tennessee
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[08:51:00 am]:Sherry
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Thank you, how may
I help you today?
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[08:51:24 am]:Gordon
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Does or will the
ACA have provisions for long term care?
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[08:52:56 am]:Sherry
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Good morning.
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[08:53:12 am]:Sherry
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You are wanting to
know about Long term care?
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[08:53:23 am]:Gordon
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Yes
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[08:53:49 am]:Sherry
|
Beginning in 2014,
all new health plans must include coverage for a set of services called
essential health benefits. These benefits include:
Ambulatory services, like doctor or clinic visits Emergency services Hospitalization, like overnight stays at the hospital Maternity and newborn care, like pregnancy and delivery Prescription drugs Laboratory services, like tests and blood work Preventive and wellness services and disease management Pediatric or children's services, including dental and vision care Mental health and substance use disorder services, including behavioral health treatments Rehabilitative and habilitative services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills |
[08:54:03 am]:Sherry
|
All Marketplace
plans offer the same general set of benefits, but specific benefits may be
different in each state. Even within the same state, there can be small
differences among plans. When you fill out your Marketplace application and
compare plans, you'll see the specific benefits each plan offers.
|
[08:55:13 am]:Sherry
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You may need to
call the individual Plan.
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[08:56:11 am]:Gordon
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Alrighty then.
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[08:56:31 am]:Sherry
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I do apologize.
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[08:58:27 am]:Sherry
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Hello, are you
there?
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[09:01:08 am]:Gordon
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Sorry. Answered the
door.
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[09:01:40 am]:Gordon
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Thanks for your
help. signing off now.
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[09:02:05 am]:Sherry
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You are welcome.
Have a nice day. Goodbye.
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[09:02:06 am]:Sherry
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Thank you for
contacting Health Insurance Marketplace Live Chat. We are here to help you 24
hours a day, 7 days a week.
|
[09:02:17 am]:'Sherry' has left
the chat session.
|
[09:02:21 am]:Your chat session
is over. Thanks for contacting us, and we hope we've answered your questions.
Have a great day.
|
[09:02:21 am]: 12/4/2013
Oh, it was a great day alright – a great day for shaking the head and a
great day for incredulous mutterings.
Not that I expected long term care to be covered, but I at least
expected a simple yes or no answer.
It was impressive, however, that my question was addressed, sidestepped
and concluded in just over seven minutes – not counting the two minutes or so
that I answered the door.
Good for them!
So while I have no plans to enjoy poor health, I have prepared for it
with a long term care policy, purchased commercially.
Here’s hoping that, when the time comes, Medicare’s enrollment team
will be more effective.
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