ADLs are the everyday things you do to take care of yourself. Examples of these include:
- Transferring – Moving onto and out of a bed, chair, or wheelchair.
- Dressing – Putting on and taking off all items of clothing including braces, fasteners, or artificial limbs.
- Bathing – Washing oneself in either a tub or shower. This activity includes getting in or out of the tub or shower.
- Eating – Feeding yourself by getting food into the body from a receptacle (such as a plate, cup, or table).
- Toileting – Getting to and from the toilet, getting on and off the toilet, and doing related personal hygiene.
- Continence – Being able to control bowel and bladder function, or being able to manage personal hygiene (such as a catheter or colostomy bag).
“ADLs are taken for granted when we are younger and able-bodied.”
As a policyholder begins struggling with one or more of these they would need to communicate or exhibit to their primary care physician or caretaker. It is important to make sure it is recorded in medical records. It is also critical to be open and honest about these vulnerable topics, so that you can receive help sooner rather than later.
Once the ADL requirement is met, someone would call policy holder services at the insurance company where the policy was purchased from. Example: Mutual of Omaha, National Guardian Life, OneAmerica. Obtain a claim form and submit all support documents requested on the form.
The carrier will look everything over, request medical records or approval from your physician, and then approve the claim. Before benefits are paid, the elimination period must be satisfied. The elimination period is the number of days the policyholder must pay for service while remaining eligible for benefits, like a deductible.
The policyholder, or a member of their support team, must submit written invoices for covered services in order to receive policy benefits, often on a monthly basis. The policyholder may choose to have the carrier pay all approved long term care expenses directly to the service provider or be reimbursed for qualifying expenses they pay themselves. The carrier will review the Long Term Care Insurance claim periodically to ensure the policyholder remains eligible for benefits.
“It is critical to be open and honest about these vulnerable topics, so that you can receive help sooner rather than later.”
ADLs are taken for granted when we are younger and able-bodied. As we get older the need for assistance with even the simplest things becomes more evident. If you’d like to protect your lifestyle, request a free quote for long term care insurance today. Gain peace of mind and guaranteed protection.
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