A client asked me a question during a sales presentation which I had never considered and didn't know the answer.
Question: Say you have a LTC policy with a 90 day elimination period and it includes a bed reservation benefit. After a short hospital stay you enter a nursing home under skilled care. You are there for 45 days when you are readmitted to the hospital, later returning back to skilled care in the nursing home. Medicare and your supplement cover 100% of the nursing home costs but none of a $300 bed reservation charge. Once you have met your 90 day elimination period, will the LTC policy go back and cover the bed reservation charge?
I called the carrier to ask this question. They told me there is no exact answer, that a situation like this would be handled on a case by case basis during a claim for benefits.
This seems like a relatively simple question that the carrier should be able to answer, don't you think?
Question: Say you have a LTC policy with a 90 day elimination period and it includes a bed reservation benefit. After a short hospital stay you enter a nursing home under skilled care. You are there for 45 days when you are readmitted to the hospital, later returning back to skilled care in the nursing home. Medicare and your supplement cover 100% of the nursing home costs but none of a $300 bed reservation charge. Once you have met your 90 day elimination period, will the LTC policy go back and cover the bed reservation charge?
I called the carrier to ask this question. They told me there is no exact answer, that a situation like this would be handled on a case by case basis during a claim for benefits.
This seems like a relatively simple question that the carrier should be able to answer, don't you think?