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Mark L. Hopkins: Long-term care insurance policies

Mark L. Hopkins More Content Now

Reading the title of this column you might think it is an advertisement for the sale of a long term care insurance policy. It isn’t. In fact, it is just the opposite. Much of what follows is very personal with me, perhaps too personal to be published in newspapers across the country. Too bad. Readers need to be aware of some of the hazards related to long-term care insurance policies. Let the insurance folks sue. As a boxing commentator used to say, “I tell it like it is.”

On the national level we talk a lot about universal insurance coverage, the next generation after Obamacare. We all need to remember that insurance companies are in the business of taking in premiums. Unfortunately, they are exceedingly adept at not paying out claims. The end result for people who need help from their insurance companies to handle the ever higher prices for medical services is a constant fight to get some of their money back when insurance coverage is needed.

Twenty years ago when my wife and I were approaching 60 years of age we made what we thought was a prudent decision to help cover future necessities for health care as we aged. We bought a long-term care plan for each of us. The cost? We have paid the carrier approximately $220 a month for almost two decades. If you are counting that is approaching $40,000.

Today, we need their help. My wife has stage 4 cancer that she has been fighting for almost two years. We could use the long-term care coverage we have been paying for. Unfortunately, they say she does not meet the requirements in the fine print of the policy. As is generally true, the devil is in the details and the details are in the fine print. There is a cover sheet that says whenever the doctor testifies that she meets their necessities we will have 90 days to wait before payments can begin. That is pretty standard and my signature is at the bottom of the page where the 90-day waiting period is noted. The monthly coverage is $135, not quite enough to cover a monthly rate at a local assisted living unit but enough to be helpful.

What is not there and is nowhere I can find on any document with my signature on it is the requirement that my wife be unable to feed or dress herself prior to applying for the coverage. I am sure I didn’t agree to that but it is certainly in the fine print that they have sent me to justify their decision not to begin payments. Reason tells me that such a requirement makes no sense. By the time a person cannot feed or dress herself, one can assume that the end will not be long in coming. In many communities, Hospice, a free service, will have stepped in with their services and taken over helping take the person toward their end.

So, did I do a dumb thing 20 years ago and agree to pay $40,000 for something that is simply not feasible? I don’t think so, but proof is not on my side. They have the money and the lawyers to fight whatever resistance they receive from me.

So, what is the solution to my problem? In truth, there may not be one. My purpose for writing this column is to warn those who don’t have such policies not to buy and those who do to read the fine print. A good alternative is to take the amount that the policy costs and put it in the bank each month in a savings account. When you need it, perhaps 30 years down the road, it will be there for your use and you will not have to fight with anyone to get the help you need.

You can reach Dr. Mark L. Hopkins at marklhopkins@att.net. Books by Hopkins, “Journey to Gettysburg, The Wounds of War, The World as it was When Jesus Came,” and “Facts & Opinions on the Issues of our Time,” can be acquired at Amazon.com, Barnes & Noble, and through the email above.