My father has paid on a LONG TERM Care policy with a home health rider for over 20 years. Despite submitting records on diagnosed illnesses and hospital stays, CNA has determined that an 88 year old man who cannot remember to take medicine, who can no longer drive, who cannot remember to turn the stove off, who falls at least once a week in his home, is not entitled to home health care services under his policy. They have determined that his five doctors must be wrong in determining that it is a medical necessity that my father have support at home and they have determined that they will not reimburse him for any home health care expenses. Furthermore, CNA maintains that they are a reimbursement policy so they dont have to provide me with any guidance onwhat they may need to help them determine medical necessity. CNA employees who are not doctors or nurses feel that they have enough knowledge to counteract his doctors recommendations and make thier own determinations of medical necessity.in the letters denying benefits they have even said that because his family provides services daily, then home health care is not needed. However, the family must provide services because CNA will not pay benefits under this rider. They have said that because he uses a cane, he is fit and can walk around. Also because he can transfer from chair to chair by himself, he does not need services. It does not matter to them that all his medical providers have recommended home health care so he does not continure to injure himself or ignore medication. BE VERY WARY of buying any type of insurance from this company. They demand timely premiums but are reluctant to pay any benefits.
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