Among other states, Oregon is believed to possess one of the most flexible long term care system in the nation. With the belief that Oregon citizens have t…
Among other states, Oregon is believed to possess one of the most flexible long term care system in the nation. With the belief that Oregon citizens have the right to where they want as they age, they have the sole right to choose and determine appropriate services from their doctors, families and others who care for them.
In this state, most people desire to live as independently as possible. Usually, they locate in a private home or apartment, only one level but provide a convenient and comfortable environment. This is usually covered within insurance policies sold together with the benefits payable for a minimum of two years. For longer periods, coverage is also offered accordingly to the need and type of care the policyholder requires.
Also, the state’s law requires LTCi policies to pay for covered services provided through a nursing home, assisted living facility, home care, and adult foster care. This simply means that an LTC policy protects a policyholder’s assets against expenses for care. In some cases, most policies limit the total benefit they will pay over the life of the policy. But in some state, the maximum benefit limit is either in years or in dollar amount. The more coverage the holder gets, the less possibility he will run out of funds to pay for care.
In OR, the first 30 days after an individual pay for a LTC policy is considered a “free look.” This mean the policyholder still have the freedom to change mind and get a full refund. This is done through sending a formal notice of cancellation and refund addressed to the insurance company only.
Every LTC policy in OR must provide alternatives when rates increase, so that policyholders can maintain their current premiums for reduced coverage rather than losing their coverage. Also, it must provide conversion or continuation options for policyholders who lose group coverage as well. LTC benefits for in-home care, assisted living facilities, adult foster care, and nursing home care and must be at least as easy to qualify for in-home care as for a nursing home. Its nursing home benefits must also cover custodial nursing care, intermediate nursing care and skilled nursing care which all depends on the care necessities.
Insurance companies must also offer optional inflation protection to increase benefits over time as the cost of covered services. And, include provisions to prevent unintentional lapses of coverage if the policyholder becomes incapable of paying a premium on time or forgets to pay.
But insurers in this state do not only base coverage solely on a patient’s diagnosis. Patients must be able to qualify for LTC benefits based on their need for help with activities of daily living such as eating, dressing, mobility, personal hygiene and toileting.