The most terrifying words in the English language:
I’m from the government and I’m here to help.
Could your Uncle Sam be creeping into providing long-term care benefits?
Long-Term Care Fake News?
Whether you watch CNN or Fox, you know with 100% certainty that it is the other side that is 100% responsible for 100% of the fake news. While we would love to settle that debate here, we’re not going to alienate 1/2 of our customers.
Unfortunately, we have our version of fake news in the LTC Insurance industry. It lies in a total state of confusion regarding who pays for what services and under what conditions, specifically Medicare, Medicaid (MediCal) and Medicare Supplements.
On October 8, 2018, Think Advisor’s Allison Bell published “Long-Term Care Benefits creep into 2019 Medicare Advantage Plans.”
I am once again flustered by the article and its title.
Before you go read further, you may want to refer to our December 2017 article, “The Blind Leading the Blind.” I would recommend you take the time to read it and reread it before you start this article.
In that article, we go back to 1987 when I received my first training on Long-Term Care and LTC Insurance, when consumers were constantly using the objection that “Medicare or my Medicare Supplement will take care me.”
I fast forward to 2017, where Genworth completed a three month nationwide consumer survey surrounding the issues of Long-Term Care:
- Two out of three people polled said they expected or believe that the government partially or fully covers the cost of their Long-Term Care services.
- In addition, 45% percent of survey participants either confused Medicare with Medicaid or admitted that they did not know the difference between the two programs.
Think Advisor’s Allison Bell published another article in May 2018, “Official Gives Hints about Medicare Advantage LTC Benefits.”
The article suggests Medicare Advantage plans can cover adult day care services, in-home help with activities of daily living and help with managing medications. As I read on, I began to see the problem.
Seema Verma, the administrator of the Centers for Medicare and Medicaid Services (CMS), says they didn’t use the terms “long-term care” or “short-term care,” but the benefits they describe appear to be similar to the benefits many private LTC Insurance policies offer through home health care and community care provisions.
They go on to say that the so-called supplemental benefits must be based on the supplemental benefits interpretation guidelines and must make sure the benefits are “primarily health related” (that means medically-based/skilled care) and not primarily for the patients comfort (as in not custodial care).
Oh … and here it comes – “services covered must be recommended by a physician or other licensed medical professional as part of a care plan.”
Folks, this is all the markings of a medical-based, skilled level of care benefit and limited benefit/feature … at best!
Now comes my point. Agents are going to read this and those who truly don’t understand what this means may give false and or misleading information to their clients during the Medicare enrollment period, or when asked questions regarding Medicare Part A vs Medicare Advantage options and benefits, they may say it covers long-term care benefits.
No, No, No … these are not long-term care benefits!
Let’s go back to the original article I refer to the beginning – “Long-Term Care Benefits creep into 2019 Medicare Advantage Plans.” According to the article, Medicare Advantage Plans issuers seem to be taking a quiet, careful approach to adding home and community based long-term care benefits for 2019.
In Arizona and California for example, units of Anthem are openly stating that they will use the new flexibility to beef up the benefits offered by some plans. Enrollees in certain Anthem plans will have access to what amounts to “long-term care benefits” provided for a “short period of time:”
- Three (3) meals delivered per day for up to 42 days
- Four (4) 4-hour shifts of in-house assistance with daily living activities, such as laundry
- Forty (40) hours of respite care for caregivers per year
- One (1) visit per week for adult daycare center services for older adults who need supervision.
- Health care appointment transportation services
Traditionally, commercial insurers have referred to benefits for small amounts of long-term care services with terms such as “convalescent care benefits” or “short term care benefits.”
Are you beginning to get it? This has nothing to do with a long-term care!
I don’t know if this is just based on ignorance (lack of knowledge) or if it is just malice (wrongful intention), but it gives a false sense of security and is absolutely, positively, 100% long-term care fake news!
For the record, here’s our definition of long-term care:
Long-term care encompasses the organization, delivery and financing of a broad range of services and assistance to people who are severely limited in their ability to function independently on a daily basis over a relatively long period of time.
Although there is no accepted definition of “relatively long period of time,” the 1982 and 1984 national long-term care surveys defined chronically disabled elderly as those whose limitations had persisted or were expected to persist for at least ninety days.
“Facing the Cost of Long-Term Care”
Dr Robert Bruce Friedland
Employee Benefit Research Institute
Are we talking about short-term care? How is that defined? Are we talking about convalescent care? Are we talking about “health-based care” or “chronic-based care?” How do they differ?
This is what I have always been talking about – Medicare, Medicare Advantage, Medicare Supplements – all equal “medical-based, short-term, restorative care.”
All this is doing is creating a state of confusion and it gets even better! As we come to the end of the Think Advisor article, it concludes by saying:
“Issuers of private LTC insurance once treated Medicaid and Medicare benefits that crowded out private insurance benefits as a serious problem. In recent years, as low interest rates and strict rate increase rules and actuarial projection problems reduced private insurers participation in the LTC insurance market, the private insurers themselves have talked about the need for a public-private partnership.”
I can’t make this up!
The California Partnership for Long-Term Care was launched back in 1994. The Federal Deficit Reduction Act (DRA) Partnership Program was launched in January 2006 and is now in 44 states!
Yet, our “long-term care fake news” thinks insurers are just now starting to “talk about” the idea of public-private partnerships! Hello!
If you are looking to sell more LTC Insurance and seize the greatest marketing opportunity in the history of insurance, sign up today for our new LTC Education package, which includes:
27 Hours of California Insurance Continuing Education Credit plus LTC Insurance Sales Education, including:
- California Partnership for Long Term Care CE Course (8 Hours – Classroom)
- California Long-Term Care Insurance CE Course (8 Hours – Webinar)
- California Hybrid LTC Solutions (SB 281) Online CE Course (4 Hours)
- California Annuities Online CE Course (4 Hours)
- California Ethics Online CE Course (3 Hours)
In addition, you’ll have access to all of our LTC Insurance sales training and tools:
- Long-Term Care Client Education Fundamentals
- LTC Insurance Client Education Fundamentals
- LTC Insurance Prospecting Skills
- LTC Insurance Sales Interview
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- LTC Insurance Sales Tools
As in added bonus, if you sign up for our LTC Education Program before the end of October 2018, you’ll enjoy a one-hour phone consultation with me, Tom Orr, to discuss your LTC sales strategy or any questions you have about marketing and selling LTC Insurance.
Let’s beat the long-term care fake news together!