Adult Family Homes

[ltcadviser]

I had a distinct impression that people on this forum loath Medamerica (gasp, it is not Genworth, and as I have learned, no GNW, no Mass Mutual - no business).

And she is back...Mrs. Ltcfp4Sure.

 

[goillini52]

I have a prospective client who is balking at LTCi because of a bad experience with her mother. The mother had an LTCi plan through Genworth (not sure how long ago she got the policy, but it was quite a while). The daughter put her in an adult family home when she eventually needed assistance, but the insurance refused to pay because it was neither assisted living nor a nursing home. From what I've read about the new policies, this shouldn't be an issue because the trigger on most of the plans are ADL based not environment based.
Her issue is she and her husband would want to go into an adult family home if they need assistance later on. Since this didn't work for her mother, she's afraid it won't work for her. Is there any policies I should be looking at in particular for her?

64/F HTN
65/M kidney and CAD. Has stents several years ago

I guess the mom's policy was too old to have what John Hancock calls an Alternate Services Benefit.

 

[ltci4sure]

And she is back...Mrs. Ltcfp4Sure.

Mr "500k placed with no lead cost" not happy to see me?

 

[ltcadviser]

Mr "500k placed with no lead cost" not happy to see me?

Can't see a ghost.................

 

[unic.consulting]

I guess the mom's policy was too old to have what John Hancock calls an Alternate Services Benefit.

I'm not sure if it was too old for that. I'm not sure why they chose Genworth.

 

[goillini52]

I'm not sure if it was too old for that. I'm not sure why they chose Genworth.

I stopped selling LTCi around 10 years ago, but many companies had an Alternative Care feature to allow for future types of care that hadn't been developed yet. It required an agreement between the policyholder, the company and the Dr. I assume that if that feature was in her policy, someone would have spotted it?

 

[ltcadviser]

I stopped selling LTCi around 10 years ago, but many companies had an Alternative Care feature to allow for future types of care that hadn't been developed yet. It required an agreement between the policyholder, the company and the Dr. I assume that if that feature was in her policy, someone would have spotted it?

In my Genworth policy the Alternate Care Benefit applies for covered expenses furnished with Mutual Agreement not specifically covered under another benefit AND not specifically excluded from payment. Under Assisted Living benefit under Excluded Places a specific exclusion extends to facilities that do not fully satisfy the definition of ALF. Thus, Genworth may not allow an Adult Family Home to fall under its Alternate Care benefit.

 

[Mr_Ed]

Coronary. She hasn't gotten back to me about the level of the kidney disease yet.

This whole thread is pointless.

The kidney disease will prevent this person from qualifying for any type of long-term care insurance--not even any of the worthwhile "combo" products.

underwriting,
underwriting,
underwriting,
that's really all that matters today.

 

[ltcadviser]

This whole thread is pointless.

The kidney disease will prevent this person from qualifying for any type of long-term care insurance--not even any of the worthwhile "combo" products.

underwriting,
underwriting,
underwriting,
that's really all that matters today.

U r right; hubby is dead application walking.

But wifey is insurable. So, thread is half pointless.

 

[unic.consulting]

This whole thread is pointless. The kidney disease will prevent this person from qualifying for any type of long-term care insurance--not even any of the worthwhile "combo" products. underwriting, underwriting, underwriting, that's really all that matters today.

No, it's not pointless because, unlike some threads on here, it actually applies to more situations than just the one originally listed. Just because this couple may not qualify doesn't mean others won't.