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Is It Challenging to Collect on Assisted Living Insurance?
Date Updated: July 26, 2024
Written by:
With over a decade of dedicated experience, Andrea Miller boasts an extensive background in healthcare writing and editing. Her expertise spans various facets of the healthcare industry, with a particular focus on nursing, senior care, Alzheimer’s disease, and public health. Andrea has also contributed her editorial talents to reputable publishers in the Philadelphia region, complementing her extensive freelance work.
Reviewed by:
Kristi Bickmann, a licensed Long-Term Care Specialist, represents top-rated "Traditional" & "Hybrid" LTC companies. Serving associations such as the American Nurses Association, she's a licensed insurance agent in 27 states. Specializing in insurance products for seniors, Kristi helps hundreds of families every year protect assets, retirement, and loved ones. She understands aging concerns firsthand, having assisted her own parents. Kristi ensures accuracy on topics about senior long-term care and its consequences.
It is challenging to collect on assisted living insurance for many adults. In addition, seniors often experience long wait times and coverage denials when they file claims. Many LTC insurance companies have gone out of business, leaving policyholders without coverage.
How many claims do assisted living insurance companies deny?
Assisted living insurance companies deny more than 47% of claims for adults aged 70 to 74, according to data from the American Association for Long-Term Care Insurance. In addition, LTC insurance companies deny more than 38% of claims for adults aged 65 to 69, more than 30% of claims for those aged 60 to 64 and more than 20% of claims for seniors aged 50 to 59.
When do assisted living insurance companies pay for care?
Assisted living insurance companies pay for care when you need help with two or more activities of daily living or have a cognitive impairment. The claim should include details from your health care provider about your medical condition and the type of assistance you need as a result of your symptoms.
You also have to wait until the end of your elimination period to receive assisted living benefits. When you buy your policy, you’ll choose a waiting period of 30, 60 or 90 days. You must pay your assisted living cost during this period, which starts when you file the initial claim for benefits.