Assisted living facilities and financial verification

[Anonymous]

My parents have a long-term care insurance policy that pays significantly for assisted living and nursing care once they need it. My father is already in the position of qualifying for use of the policy and needing long term care. However, now that we are looking at facilities, we are finding that they are requesting information on assets rather than the insurance policy. My father has a pension but does not have assets beyond his pension (government pension of $80K per year). His plan was to pay for long term care through the insurance policy and we believe they will pay. Will long-term care facilities turn him away because he does not have other assets? How can we find the long-term care facilities that will take his insurance?

[Anonymous]

They just want the monthly bill paid.

[Anonymous]

My dad entered AL this summer and we were told by most places that they wanted to see that he had sufficient assets/income to "full pay" for 2 or 3 years before reverting to Medicare.

(My mother stayed in the house, so we only included my father's income on the forms)

I also noticed that none of the places actually checked or verified any of the info we provided

[Anonymous]

With all due respect, insurance policies typically don’t pay what you think they will or should. That is why facilities require you to demonstrate assets. My spouse has been running elder care facilities for decades. We have never purchased LTC insurance because in my spouse’s experience, they usually don’t pay or don’t pay much.

[Anonymous]

Anonymous wrote:My dad entered AL this summer and we were told by most places that they wanted to see that he had sufficient assets/income to "full pay" for 2 or 3 years before reverting to Medicare.

(My mother stayed in the house, so we only included my father's income on the forms)

I also noticed that none of the places actually checked or verified any of the info we provided

Medicare doesn’t pay for AL so he will never revert to Medicare for AL. And it only pays for nursing home care for a short period after a qualifying hospital stay. They probably said Medicaid.

[Anonymous]

We moved my MIL into a facility with a govt pension (90K a year), long term care and also required assets. She has about 150k from sale of the home she had to show. Like others said the insurance doesn't pay for her entire monthly and she is on what they consider a fixed income-- nothing beyond her pension. She is in a two bedroom independent living with one meal a day which is 8k a month. Insurance will only cover 4k which is fine for now. We are hoping to get rid of her car because she pays for insurance, gas, etc. as she needs more care her monthly will go up but insurance won't. She hasn't had to use her nest egg but I keep telling my DH she is on fall away from disaster.

[Anonymous]

PP here. I should add that her policy has a time limit (7 years?) and a max yearly amount which is how we got to the 4k a month. She is 84 which is what makes me a bit concerned that she is going to outlive her benefit or quickly require a much more costly amount of service.

[Anonymous]

Our assisted living facility did not even ask for proof of funds and did not even know we had LTC insurance. I was somewhat surprised they did not ask for proof of funds. This facility is even a step up from a regular LTC facility as they have a higher level license and more people allocated to each patient. And they had a waiting list which we were on. They are also a certified memory care facility whether you need it or not. Our LTC insurance has paid out as planned. Parent (92 yrs old) is well and has been there 3 yrs. They must have assumed we had the funds and of course if we did not then would get evicted.

[Anonymous]

Anonymous wrote:My dad entered AL this summer and we were told by most places that they wanted to see that he had sufficient assets/income to "full pay" for 2 or 3 years before reverting to Medicare.

(My mother stayed in the house, so we only included my father's income on the forms)

I also noticed that none of the places actually checked or verified any of the info we provided

This makes no sense. It's long term care medicaid and usually they want a few months but in this area medicaid does not pay for AL. Other states do pay for it.

[Anonymous]

My mom’s facility does not “take the insurance” or charge to insurance. All the facility does is confirm to the insurance company that she resided there each month. The insurance company sends the check to her, and she pays the facility from her bank account.

[Anonymous]

Anonymous wrote:Our assisted living facility did not even ask for proof of funds and did not even know we had LTC insurance. I was somewhat surprised they did not ask for proof of funds. This facility is even a step up from a regular LTC facility as they have a higher level license and more people allocated to each patient. And they had a waiting list which we were on. They are also a certified memory care facility whether you need it or not. Our LTC insurance has paid out as planned. Parent (92 yrs old) is well and has been there 3 yrs. They must have assumed we had the funds and of course if we did not then would get evicted.

Thanks for this information. What is the name of your assisted living facility?

[Anonymous]

Anonymous wrote:My dad entered AL this summer and we were told by most places that they wanted to see that he had sufficient assets/income to "full pay" for 2 or 3 years before reverting to Medicare.

(My mother stayed in the house, so we only included my father's income on the forms)

I also noticed that none of the places actually checked or verified any of the info we provided

Thanks for this. If most places asked for this, it sounds like it is pretty widespread. I wonder how people who don't have assets can get into AL or nursing care? Or is it only for rich people even if they have LTC insurance?

[Anonymous]

Anonymous wrote:

Anonymous wrote:My dad entered AL this summer and we were told by most places that they wanted to see that he had sufficient assets/income to "full pay" for 2 or 3 years before reverting to Medicare.

(My mother stayed in the house, so we only included my father's income on the forms)

I also noticed that none of the places actually checked or verified any of the info we provided

This makes no sense. It's long term care medicaid and usually they want a few months but in this area medicaid does not pay for AL. Other states do pay for it.

Does medicaid pay for AL in Virginia?