Enjoying Poor Health

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

Does or will the ACA have provisions for long term care?

[08:50:21 am]:Sherry

Welcome to the Health Insurance Marketplace web chat, to better assist you, may I have the State in which you reside?

[08:50:33 am]:Gordon

T

[08:50:37 am]:Gordon

Tennessee

[08:51:00 am]:Sherry

Thank you, how may I help you today?

[08:51:24 am]:Gordon

Does or will the ACA have provisions for long term care?

[08:52:56 am]:Sherry

Good morning.

[08:53:12 am]:Sherry

You are wanting to know about Long term care?

[08:53:23 am]:Gordon

Yes

[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

You may need to call the individual Plan.

[08:56:11 am]:Gordon

Alrighty then.

[08:56:31 am]:Sherry

I do apologize.

[08:58:27 am]:Sherry

Hello, are you there?

[09:01:08 am]:Gordon

Sorry. Answered the door.

[09:01:40 am]:Gordon

Thanks for your help. signing off now.

[09:02:05 am]:Sherry

You are welcome. Have a nice day. Goodbye.

[09:02:06 am]:Sherry

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.