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Long-Term Care Enrollees Urged to Use Coordination

Though many enroll for the Federal Long Term Care Insurance Program, very few know what long-term care is and how to get the greatest benefit from it, an official with the program said.

"People have very little understanding until they really need it what long-term care is and what long-term care insurance will be able to do for them," Mary Lou McGuinness, a nurse and director of care coordination/claims for the Federal Long Term Care Insurance Program, said. "I think the understanding is diminished because it is a very complicated subject.

"And I think when they have an immediate need for the services, that's when they tend to try to tap into whatever resources they have to give them the information to answer their questions," she continued. "The problem is that the need for the knowledge is often very urgent by the time they need it."

To avoid the emotional toll on caregivers charged with making decisions about a loved one's care, McGuinness suggests utilizing the program's care-coordination services to develop a plan for the future. Having an idea of what is available before there's a critical need can alleviate some of the stress involved in decision making.
Coordinators, all registered nurses who have worked in long-term care situations previously, are available to assist with that process. They can provide general information, assessment and approval of the need for long-term care and help develop a care plan.

Also, for consistency, enrollees are assigned a coordinator who will monitor and reassess the services being provided and provide access to discounts for services, when available. The coordinators also check the licenses of long-term care facilities or provide caregiver training for individuals. In any case, the enrollee has the final say in the care plan.

McGuinness also reminded enrollees that the coordination services extend to qualified relatives. This can be especially helpful if the enrollee does not live in the same state as his or her parents.

While qualified relatives are not eligible to receive benefits beyond the coordination services, they can get help in coordinating the benefits they do have through private insurance or Medicare.

There is often confusion about what long-term care insurance will cover. Essentially, McGuinness said, if care is needed for more than 90 days, long- term care could apply. Severe cognitive impairments, such as Alzheimer's disease, also qualify for long-term care.

The Federal Long Term Care Insurance Program is meant to cover expenses associated with long-term care available in a nursing home, assisted-living facility or an enrollee's home.

Launched in March 2002, the program is the largest employer-sponsored long-term care insurance program and the largest group program in the country. The program provides over 20 million eligible enrollees access to long-term care insurance as a voluntary benefit, meaning the employee pays all costs.

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