When we work with families trying to file a long term care insurance claim, we inevitably have to slow down and explain some “jargon”.

Insurance has its’ own language sometimes (I mean it! Have you EVER heard “deductible” anywhere but in insurance?!?). Long term care insurance has an even denser set of vocabulary requirements because it is a specialty niche. And unfortunately, family members (who have no idea about all this lingo) are the ones trying to learn fast enough to be effective at filing the long term care insurance claim.

So let’s handle some of the basic alphabet soup of long term care insurance:

ADL’s Activities of daily living, usually transferring, bathing, eating, dressing, toileting and continence. Policies will specify that you have to need help with one or more of these to be claim eligible.

ALF Assisted Living Facility, sometimes called “custodial care” or “intermediate care”. Custodial care is usually for folks with cognitive impairment.

DVN Daily Visitation Notes – produce each day by the hoe heatlh care worker, these indicate exactly what was done in terms of care for that visit. These are required as part of the documentation for a claim for home health care.

HHC Home Health Care. Agencies may or may not be licensed by the state. Most policies require a licensed care provider. So if you are filing a claim, ASK whether there is a license and learn if your policy requires one.

NH Nursing Home, sometimes called “skilled care”

MDS Minimum Data Sets. This is the document nursing homes and rehab units use to note what types of medical issues a person is having and the level of care needed to meet their needs.

MMSE Mini-mental State Exam – one of the common clinical tests to determine a persons level of cognitive ability

If you are wondering, “is there more” – the answer is yes. But these are some of the most basic and will get you started sorting thru the confusing jargon of filing a claim for long term care insurance.

 


 

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Long Term Care Claims & Insurance

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