Assisted Living vs. Nursing Homes: What's the Difference?

Managing the logistics of caring for a loved one can be overwhelming, stressful, and confusing. Financing in-home care can also be complicated, but long-term care (LTC) insurance can be a helpful resource to offset the cost of care. If you or your loved one have long-term care insurance, its important to understand the nuances and coverage aspects of your policy before filing a claim to pay for home care services.What is Long-Term Care Insurance for Home Care?Each long-term care (LTC) policy is different, but generally, they all require that the insured individual meets specific criteria to begin receiving benefits in the home or other setting. For example, you may be eligible for benefits if:You have a cognitive impairment or need help with two or more of these Activities of Daily Living: eating, dressing, bathing, toileting, getting in and out of a bed or chair, and bladder or bowel control. A care manager or nurse from your insurance company typically assesses the need and determines your eligibility. You are past the elimination period, which is like other insurance deductibles except its measured in days instead of dollars. Whether your elimination period is 30, 60 or 90 days, you must cover the cost of any services for this time before your insurance company starts to pay.Depending on your provider, policy differences dictate what services are covered for your loved one. When reviewing your policy to understand whats covered, examine factors like the maximum amount paid per day of care, the maximum number of years the policy will pay for benefits and lifetime maximum payment amount. Because these factors vary greatly from plan to plan, its critical to be fully aware what your policy covers and how much you may need to pay out-of-pocket.What Are the Types of Policies of LTC and Do They Cover Home Care?Long-term care policies are generally offered as either a traditional stand-alone policy or a hybrid option alongside a life insurance policy. Some hybrid options, such as a linked benefit life insurance policy, allow you to access the death benefit of a traditional life insurance policy while your loved one is still alive and needs care. Other options, such as a long-term care rider add-on to a life insurance policy, have a separate portion of funds that are earmarked for long-term care benefits.Many comprehensive policies cover services such as skilled nursing in-home care, support with activities of daily living (ADLs), occupational and physical therapy, as well as rehabilitation. However, more limited policies may not cover all of these services. Each policy has their own set of specifics that must be fully understood before submitting a claim. If you have questions about your policy, discuss them with your insurance provider to gain clarity and also confirm that your care provider-of-choice accepts your insurance and what options are available to you.Filing a Claim for Home Care ServicesCarefully review your policy or ask your LTC insurance provider:How many Activities of Daily Living do I need to require help with before I qualify? Does requiring help due to a dementia diagnosis count? What is my elimination period? Is it calendar days or days of paid care that may be stretched out over several months? Are there a minimum number of hours per day I need to pay for in order for it to count as a day of care?Are a physicians orders needed to qualify?What is my daily, weekly or monthly maximum? Do I have an inflation clause?Can I stop paying premiums once I activate the policy?If I stop needing care or am hospitalized, does the elimination period start over?To learn more about how you can leverage your long-term care policy for home care services, contact your local BrightStar Care agency today.Common Mistakes to Avoid When Filing a ClaimIf its your first time using long-term care insurance, it can be a confusing process.  LTC insurance doesnt always work the same as other types of insurance. The most common mistake made when filing a claim is not adhering to the policys elimination period the waiting period before the policy will begin paying for services. During this period, the policyholder is expected to pay for services out-of-pocket. The elimination period is determined at the time of purchase and can vary from 30 days to a year or more. Other common mistakes to avoid are similar to those stumbling blocks that often materialize with more traditional forms of health insurance. When filing a claim, make sure to provide a clear, detailed account of your loved ones level of function and their medical needs. Submit consistent and complete medical documentation to accompany each claim and make sure to file all claims on time.Using Long-Term Care Insurance to Pay for Home CareKnowing if your family member has a long-term care insurance policy and what type of policy it is means you have additional resources to support their care. If LTC insurance is an option for your family, here are some helpful tips to follow if you plan to use this insurance to help pay home care for your loved one. Review your policy: Familiarize yourself with the type of policy your loved one has, what services it will cover and how long it will cover their needs. If you have a hybrid plan, youll also want to consider how your particular LTC insurance may impact a traditional life insurance policy. Consult with your providers: Always follow up with your insurance provider to make sure you are clear on your policys coverage. You should also consult with your healthcare provider to gain access to all necessary documentation for your insurance claim.Choose a licensed home care provider: Selecting a home care provider should include such considerations as their vetting and training practices, standard of care, licensing protocols and accreditation. Submit a claim: Follow your insurance providers process for filing a claim. Include all documentation and follow proper timelines to ensure timely payouts for services.Monitor and adjust: Stay up to date on the particulars of your insurance coverage and what that means for the medical needs of your loved one. Both may change without notice, potentially leaving the door open for a gap in coverage when your loved one needs it most. Making sure youre aware of any upcoming changes will allow you to adjust care and policy coverages as needed.How to Maximize Your LTC Insurance BenefitsNavigating the complexities of long-term care insurance benefits can be complicated, but by asking the right questions of your insurance provider and healthcare professionals, you can develop a better understanding and reap the full benefits of your plan. Here are a few tips and strategies to help you make the most of your LTC policy:Work with a care manager: Having a care manager that is familiar with LTC insurance policies will help maximize your benefits. An experienced care manager has a working knowledge of various LTC insurance policies and can help you understand what options are available to you and for how long. They can also help you find additional resources to offset any costs not covered by your LTC insurance. Use preferred home care providers like BrightStar Care: BrightStar Care has provided professional in-home care to individuals and families for decades. Weve worked with a variety of insurance providers and can help you understand your coverage options. When you choose preferred care providers, your claim process can be easier and faster. Opt for home-based care to reduce out-of-pocket costs: LTC insurance elimination periods vary from policy to policy, ranging from periods as short as 30 days to up to 1 year or longer. In-home care offers greater flexibility and tailored care solutions that are typically billed hourly, allowing individuals to only pay for the services they need on a part-time basis, rather than a fixed rate at a skilled nursing facility. Additionally, in-home care eliminates the added costs of upfront facility deposits or admission fees. These cost-saving factors make home-based care a more budget-friendly option during the waiting period before LTC insurance benefits kick in.BrightStar Care: Your Trusted Partner in Navigating Long-Term Care InsuranceAt BrightStar Care, we know that the experience of caring for an older loved one can be rewarding but come with its own unique set of difficulties. Payment options like long-term care insurance gives you the peace of mind that your loved one will receive the care they need and helps ease the financial burden of paying for that care. Questions and to learn more please call us today, 303-300-6666

Many married couples share almost everything, including finances. This may be reflected in their estate plan by using one joint living trust instead of two separate trusts. Separate trusts can provide greater flexibility, but a joint trust can be structured so that when one spouse passes away, the trust is split into two sub-trusts: a survivors trust and a decedents trust. This arrangement provides the surviving spouse with the same versatility that separate trusts offer. The surviving spouse has full control over their survivors trust, but may have limited control over the deceased spouses accounts and property that make up the decedents trust. Decedents Trust and a Survivors Trust A survivors trust is a middle ground between a joint trust and separate trusts. If a couple chooses to combine their assets (accounts and property) into a joint revocable living trust, both spouses will usually be named as trustees and beneficiaries. The joint trust can further stipulate that when one spouse passes away, the trust divides into subtrusts. One of those subtrusts can be a survivors trust. A second subtrust, the decedents trust, will also be created to hold and manage assets owned by the decedent. How a Survivors Trust Works A typical joint trust arrangement lists four types of property, depending on the state in which you live: Joint assets Community property First spouses separate property Second spouses separate property When the first spouse dies, the survivors trust receives one-half of the community property, one-half of the joint property, and all property identified as the separate property of the surviving spouse. The deceased spouses half of the community property and joint property, along with their separate property, may be funded into the decedents trust with its own set of instructions. The trust agreement could also state that all of the deceased spouses property will go into the survivors trust instead of going into a separate subtrust. Reasons to Have a Survivors Trust Regardless of exactly how the joint trust assets are allocated, a crucial distinction is that a survivors trust is revocable, while the decedents sub-trust is irrevocable. This means that the surviving spouse retains full control over the survivors trust. They can alter the terms of the trust however they want. For example, they can add and remove assets, change beneficiaries, appoint new trustees, or terminate the trust. The surviving spouse can also completely change the terms of the survivors trust in its entirety. While the surviving spouse may be the beneficiary of the decedents trust, the surviving spouse will likely have less control over the management of assets in the decedents trust. This allows the deceased spouse to put protective measures in place while they are alive to make sure that their assets are managed the way they want and that someone cannot change the rules after they pass away. This can be helpful for clients who are worried about their spouse remarrying after their death and to ensure that assets that remain at the surviving spouses death go to a predetermined person. The purpose of any trust is to take care of loved ones and protect assets from costly probate and taxes. To discuss an estate plan that meets your goals, please schedule your appointment with our Estate Planning attorneys - 724-375-4005.

Becoming eligible for Medicare is a significant milestone in your life. Whether you are newly turning 65 or approaching eligibility due to disability, understanding your Medicare options can feel overwhelming. With multiple parts, plans, and enrollment periods, making the right choice is essential to protect your health and finances.Thats where Inman Medical Insurance Services steps in helping Medicare-eligible individuals and their families navigate the complex landscape of Medicare insurance with clarity, confidence, and care.Understanding Medicare: A Quick OverviewMedicare is the federal health insurance program for people 65 and older, younger individuals with certain disabilities, and those with End-Stage Renal Disease (ESRD). It consists of several parts: Medicare Part A (Hospital Insurance) covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health care. Medicare Part B (Medical Insurance) covers outpatient services like doctor visits, preventive care, and some home health services. Medicare Part C (Medicare Advantage) plans are offered by private companies approved by Medicare and include Part A and B benefits, often with added perks. Medicare Part D (Prescription Drug Coverage) helps cover the cost of medications through private plans. Choosing the right combination of these parts depends on your health needs, budget, and preferences.Why Professional Guidance Matters When Choosing Medicare PlansMedicare is not a one-size-fits-all program. With dozens of Medicare Advantage and Part D plans available in many areas, it can be challenging to understand differences in coverage, premiums, deductibles, copays, and provider networks. Making an uninformed decision could mean paying more than necessary or missing coverage for services you need.Inman Medical Insurance Services offers personalized Medicare consulting to ensure you: Understand your Medicare benefits and options Identify plans that best fit your health needs and financial situation Avoid costly penalties by enrolling during the correct periods Navigate changes to your Medicare coverage over time This professional guidance saves time, reduces confusion, and empowers you to make decisions with peace of mind.Services Offered by Inman Medical Insurance ServicesAt Inman Medical Insurance Services, youll find a trusted partner with a deep knowledge of Medicare plans and regulations. Their services include:1. Medicare Eligibility CounselingIf youre turning 65 or recently became eligible due to disability, the team helps you understand when and how to enroll in Medicare, including your initial enrollment period and special circumstances.2. Medicare Plan Comparison and EnrollmentThey analyze available Medicare Advantage, Medigap (Medicare Supplement Insurance), and Part D prescription drug plans in your area. By comparing costs, coverage, and provider networks, they help you select a plan that fits your unique needs.3. Annual Medicare Review and Plan OptimizationMedicare plans can change year to year. Inman Medical Insurance Services offers yearly reviews during the open enrollment period (October 15 December 7) to ensure your plan remains the best option, or help you switch plans if needed.4. Assistance with Medicare Appeals and ClaimsIf you encounter coverage denials or billing issues, their experts assist with navigating appeals and resolving Medicare claims, reducing stress and ensuring your rights are protected.5. Education on Medicare Savings Programs and Financial AssistanceMany Medicare-eligible individuals qualify for programs that reduce costs, such as Medicaid, Extra Help, or state pharmaceutical assistance programs. The team helps you identify and apply for these valuable benefits.Who Can Benefit Most from Inman Medical Insurance Services? Newly Medicare-eligible individuals who want to start their coverage on the right foot. Current Medicare beneficiaries seeking to optimize their plan or save money. Caregivers or family members assisting loved ones with Medicare decisions. Anyone feeling overwhelmed by Medicare's complexity and needing personalized support. Why Choose Inman Medical Insurance Services? Experienced Medicare Specialists: Knowledgeable in local and national Medicare regulations. Personalized Service: Tailored recommendations based on your health, budget, and goals. Trusted Advisor: Committed to education, transparency, and ethical guidance. Local Presence: Familiar with regional plan options and resources in Pennsylvania. Ongoing Support: Available year-round for questions, enrollment, and plan changes. Medicare FAQs Answered by Inman Medical Insurance ServicesQ: When should I sign up for Medicare? A: Your Initial Enrollment Period begins three months before your 65th birthday, includes the month you turn 65, and ends three months after. Signing up during this window avoids late enrollment penalties.Q: Whats the difference between Medicare Advantage and Medigap? A: Medicare Advantage (Part C) plans are all-in-one coverage offered by private companies and often include extra benefits like vision or dental. Medigap plans supplement Original Medicare by covering out-of-pocket costs.Q: Can I change my Medicare plan every year? A: Yes. During the Annual Enrollment Period (Oct 15 Dec 7), you can switch Medicare Advantage plans or Part D prescription drug plans.Q: How can I reduce my Medicare costs? A: Programs like Medicaid, Extra Help for prescription drugs, and Medicare Savings Programs can lower premiums and out-of-pocket costs. Inman Medical Insurance Services helps you find and apply for these.Take the Next Step Toward Medicare ConfidenceNavigating Medicare can be complicated, but you dont have to do it alone. Let Inman Medical Insurance Services guide you through the process with clarity and confidence. Their expert support ensures you select the right plan for your needs and budget, now and in the years ahead. For personalized Medicare help and a no-obligation consultation, call us today at 724-306- 8802.  6-8802