Understanding Powers of Attorney
A long term care event can occur at any time in your life. Automobile and sporting accidents; disabling events such as strokes, brain tumors, and spinal cord injuries; and chronic illnesses such as multiple sclerosis and Parkinson's disease are examples of injuries and ailments that can happen to anyone. Even the simple effects of the aging process may require long term care services.
What if a long term care event left you unable to express your views on treatment, relay your care preferences, and communicate who will make decisions on your behalf? No one likes to consider such grim possibilities, but the truth is, a loss of cognitive function can create significant hardships for you and your family.
What is a power of attorney?
In order to allow someone other than yourself to initiate the benefit eligibility process, take action on your account, or submit claims on your behalf, a formal document designating a legal representative, also known as an agent, is necessary. The most common document our insureds use for this purpose is a power of attorney (POA), and there are different kinds of POA documents.
A POA is a legal document in which the grantor, also called the principal, appoints another individual to act on their behalf, as their agent, for a specified range of matters. There are many variables and questions that should be considered when preparing a power of attorney, and many people seek the assistance of a legal advisor to draft this document. Some states have their own statutory power of attorney forms that are readily available and, when used and completed correctly, meet the requirements of the state for which they are intended. It's a good idea to ask your legal advisor if your state uses a specific power of attorney form to ensure your power of attorney is valid.
Determining the type of authorization
Once Long Term Care Partners receives your power of attorney, we will review the document to determine the type of authorization your designated person has on your behalf. For example, a standard or non-durable power of attorney for health care authorizes us to disclose information about your FLTCIP benefits to your agent so that he or she may assist you in matters related to your coverage. However, these powers remain in effect only while you are legally competent to manage your own affairs. Should you become incompetent, a non-durable power of attorney would no longer be valid. For this reason, many of our insureds create a durable power of attorney, which will remain effective and allow your agent to act on your behalf even if you become incapacitated. To learn more about the risks and benefits of durable and non-durable powers of attorney, we recommend you speak to your legal advisor.
A variation of the durable power of attorney is a springing power of attorney. This type of power of attorney is not immediately effective upon signing. As the name implies, a springing power of attorney only springs to effectiveness when the insured becomes incapacitated. It is important that the document specify the certification standard. Many insureds specify that their agent may only begin acting on the insured's behalf when their primary care physician or other licensed health care practitioner certifies via a written statement that the insured can no longer manage his or her own affairs.
Most insureds use standard or financial powers of attorney since they are typically the most appropriate documents for insurance claims submission and administration. While health care powers of attorney occasionally address medical care payments and insurance coverage, they are usually limited to making decisions regarding your medical care and following any health care preferences you've expressed. If you have any questions about the authority granted under your power of attorney, you may consider discussing the document with your legal advisor.
A valid power of attorney
In order for a durable power of attorney to be valid, you must be legally competent when you authorize someone to act on your behalf. That's why it is important to prepare a durable power of attorney while you are in good health. As a current FLTCIP enrollee, you can send us your power of attorney document to have on file at any time.
Long Term Care Partners reviews your power of attorney for clarity to be certain the document grants powers to your agent that are specific to the claims and administration of your FLTCIP coverage. We review the document carefully to ensure we act only on your authority. Please note, if you die, your power of attorney is no longer valid.
Our compliance team reviews all documents. When we receive a document from you, we will send a letter to acknowledge its receipt. If the document is in good order, we can expedite the claims process, including a determination of your benefit eligibility and care reimbursement. If we have a question or any information is missing, we will call you and, in most cases, send a letter explaining the information we need. Once your submitted document is complete and in good order, the compliance team will update your account with information about the agent(s) authorized to take action on your behalf. Your account information, including your power of attorney, will be available to all claim services consultants and your care coordination team.
If you do not have a power of attorney, you may want to speak with your legal advisor to see if it is appropriate for you. In some cases, insureds get sick, require immediate use of their long term care insurance, and, due to their illness, are not able to manage their own finances. If they have not already created a power of attorney authorizing someone else to act on their behalf, the law may consider them incapacitated and not competent to prepare one. Like all legal documents, parties need to fully comprehend the nature of the document they are signing.
In instances when the insured needs to access their insurance coverage but cannot, due to health constraints and no legal document such as a power of attorney exists, their family members may need to ask a court to appoint a guardian or conservator to assist.
If there is already a guardianship or conservatorship in place, the court-ordered authority that outlines the powers granted by the court should be submitted as soon as possible, so Long Term Care Partners can understand and comply with the orders.
If you have questions, please call our Customer Service Center at 1-800-LTC-FEDS (1-800-582-3337) TTY 1-800-843-3557.
The information here provides you with detailed background regarding a power of attorney document. It is not intended as legal advice or direction and should not be considered as such. Please consult your own attorney or legal advisor for advice and answers to any legal questions.
Your privacy and the protection of your identity and health information are important to us. As a covered entity under the Health Insurance Portability and Accountability Act (HIPAA), we are committed to safeguarding the information in your Federal Long Term Care Insurance Program (FLTCIP) account to ensure your privacy.