Anyone have a similar issue with assisted living denied by Allstate LTC?

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Badandy1 Asked June 2017

Anyone have a similar issue with assisted living denied by Allstate LTC?

My Fathers Allstate Long Term Care contract is denying Assistant Living Coverage. The contracts specifically states nursing home coverage defined as :licensed ( not specified) 24/7 nursing care under supervision of Doctor and Daily records. His facility meets these criteria and I was told many documented times it was fine. Allstate is now denying benefits stating they only cover skilled nursing . That is not in the contract. Anyone else have similar issue? I am considering a Class Action Law Suit!

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score 0 · Answer 1

This is an older policy and Skilled Nursing is never noted as a requirement, just the level of care in the contract.
They admit to paying benefits to Assisted Living, but just changed their mind this month!

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score 0 · Answer 2

Assisted living usually isn't covered by LTC. They are not skilled/licensed nursing facilities. In fact, Medicaid generally doesn't cover them either.

LTC covers skilled nursing facilities and memory care.

Angel

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score 0 · Answer 3

My mother has a LTC policy from Allstate, also. I called the agent and learned that AL facilities are not covered under her policy (although they often are with newer policies). The facility has to be licensed as a SNF (nursing home).

I haven't eyeballed the policy, and it would cause upset to my mother if I asked to look at it ("You are trying to put me away!"). I do know where it is, though, and could access it for specifics if needed.

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Anyone have a similar issue with assisted living denied by Allstate LTC?

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