Voluntary Benefits
Published by Trustmark Voluntary Benefits on October 28th, 2020
By: Adam Bezman, Senior Director, Product & Innovation & Dr. Howard Fixler, Medical Director and Second Vice President, Long-Term Care and Disability
A few weeks ago, our colleague Dan Johnson took a look at the emerging trend of carriers offering Chronic Care riders. Many of these require that the need for long-term care be permanent to receive benefits. As Dan correctly pointed out, 60 percent of Trustmark’s LTC claims are for people under the age of 65 – meaning that many people receiving long-term care are likely expected to recover from their need for care.
That’s the important point we want to focus on here – recovery from the need for care. Over and over, when we’ve discussed conditions that may result in a policyholder needing long-term care, the idea of recovery came up. Medicine, both in the treatment of acute illness as well as physical rehabilitation is advancing and, with those improvements, our ability to limit the need for long-term care is improving as well.
In that sense, permanency requirements of Chronic Care riders run contrary to the aims of doctors and medical professionals; doctors want to limit the need for care, but some carriers are only providing benefits if permanent care is needed.
Here are just a few of the examples we discussed that illustrate that point:
Strokes – Years ago, there were limited options to treat a stroke, but today, that’s not the case. Using clot busting drugs to reduce brain damage has been a game changer. Further, as far back as the late 1980’s when rehabilitation hospitals began to implement “young stroke programs” to help stroke patients recover, there’s been a greater emphasis on helping patients regain independence. Today, there are plenty of aggressive ways we can treat strokes and more rehab tools that can help patients recover. As such, the likelihood for a permanent need for long-term care from a stroke is significantly reduced.
Heart attacks – Much like strokes the tools we have to treat heart attacks are much improved (and improving all the time). Whereas before a heart attack could lead to stroke or other complications requiring long-term care, today we’re much better able to prevent permanent heart damage and resulting conditions through early intervention. The focus is more on maintaining healthy heart tissue rather than reacting to a patient’s symptoms – resulting in a faster recovery.
Illnesses – A great example of an illness that doesn’t always necessitate permanent long-term care is Multiple Sclerosis. With newer drugs and more available rehabilitation to treat MS today, you may require care for a period of time, but then recover enough to be able to function without assistive care. These newer drugs, known as actual disease modifying therapies are increasingly being developed to treat otherwise chronically debilitating conditions including Rheumatoid Arthritis.
All of these examples are just that, examples, but they illustrate the goals of the medical field: recovery and independence. With so many claims coming in for people under the age of 65 and with a medical focus on helping people get back on their feet, it seems counterintuitive to require that Chronic Care be permanent to receive benefits. On top of that, do consumers really want their insurance carriers making the determination of whether or not their condition requires permanent long-term care?
At Trustmark, our goal is always to align our products and services to the needs of our customers. And, in many case the needs of our customers are protection for the care that their doctors provide. It’s important to keep that in mind when designing products that are usable and effective in protecting our customers.
A few weeks ago, our colleague Dan Johnson took a look at the emerging trend of carriers offering Chronic Care riders. Many of these require that the need for long-term care be permanent to receive benefits. As Dan correctly pointed out, 60 percent of Trustmark’s LTC claims are for people under the age of 65 – meaning that many people receiving long-term care are likely expected to recover from their need for care.
That’s the important point we want to focus on here – recovery from the need for care. Over and over, when we’ve discussed conditions that may result in a policyholder needing long-term care, the idea of recovery came up. Medicine, both in the treatment of acute illness as well as physical rehabilitation is advancing and, with those improvements, our ability to limit the need for long-term care is improving as well.
In that sense, permanency requirements of Chronic Care riders run contrary to the aims of doctors and medical professionals; doctors want to limit the need for care, but some carriers are only providing benefits if permanent care is needed.
Here are just a few of the examples we discussed that illustrate that point:
Strokes – Years ago, there were limited options to treat a stroke, but today, that’s not the case. Using clot busting drugs to reduce brain damage has been a game changer. Further, as far back as the late 1980’s when rehabilitation hospitals began to implement “young stroke programs” to help stroke patients recover, there’s been a greater emphasis on helping patients regain independence. Today, there are plenty of aggressive ways we can treat strokes and more rehab tools that can help patients recover. As such, the likelihood for a permanent need for long-term care from a stroke is significantly reduced.
Heart attacks – Much like strokes the tools we have to treat heart attacks are much improved (and improving all the time). Whereas before a heart attack could lead to stroke or other complications requiring long-term care, today we’re much better able to prevent permanent heart damage and resulting conditions through early intervention. The focus is more on maintaining healthy heart tissue rather than reacting to a patient’s symptoms – resulting in a faster recovery.
Illnesses – A great example of an illness that doesn’t always necessitate permanent long-term care is Multiple Sclerosis. With newer drugs and more available rehabilitation to treat MS today, you may require care for a period of time, but then recover enough to be able to function without assistive care. These newer drugs, known as actual disease modifying therapies are increasingly being developed to treat otherwise chronically debilitating conditions including Rheumatoid Arthritis.
All of these examples are just that, examples, but they illustrate the goals of the medical field: recovery and independence. With so many claims coming in for people under the age of 65 and with a medical focus on helping people get back on their feet, it seems counterintuitive to require that Chronic Care be permanent to receive benefits. On top of that, do consumers really want their insurance carriers making the determination of whether or not their condition requires permanent long-term care?
At Trustmark, our goal is always to align our products and services to the needs of our customers. And, in many case the needs of our customers are protection for the care that their doctors provide. It’s important to keep that in mind when designing products that are usable and effective in protecting our customers.
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