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Filing a Long Term Care Insurance Claim

Long Term Care Insurance (LTCI) can offer the appropriate care services for you or your loved one. Filing the claim for that policy to pay for correctly for the care that you need can be quite complex when it comes down to it.

With so many different policy types, qualifications for care, and licensure of care settings, navigating this process can be confusing to say the least. At A-1 Home Care Agency, we make it easy for you to understand what you need to do to start a claim correctly.

  1. Designate a Trusted Family Member to Coordinate

The first step is considering whether or not you or your loved one needs LTCI. Once you’ve made the decision to pursue the claim, you’ll want to choose someone that you can rely on to handle calls from the physician and the insurance companies. He or she must be available to document and track all correspondence in a recorded document. Ideally, you’ll want someone that can focus on the entire process itself and not be flaky.

  1. Understand the Policy

Before you start the process, make sure you understand what the policy entails. If you don’t have a copy of the policy, be sure to call the insurance company and ask them to send a physical copy to you. If you have any doubts or questions, consult with your coordinator and the insurance company so they can break down each section of the policy to make it easier for you to understand. Remember, you don’t want to sign up for something that you don’t fully understand.

  1. Know the Benefits

There are numerous policies that cover different things. You’ll want to understand what to look for when it comes to your personal case. Some ideas to consider when reading the policy include:

  • How long is the elimination period?
  • What are the benefit triggers?
  • What is the benefit period/total pool?
  • Does this cover home care, assisted living facilities and other care settings?
  • Are there separate pool amounts for care settings?
  1. Find a Care Provider that Knows LTCI

Many care facilities and even home care agencies aren’t knowledgeable about LTCI. This can prove to be quite frustrating when it comes down to the billing process. By following up with care providers and ensuring that they accept and know about LTCI will make the process that much easier for you. Additionally, the billing offices of different care providers may only have experience dealing with Medicare, Medicaid, and private pay services. This is an underrated, yet important, step that many folks still neglect to take seriously.

  1. Follow Up With the Policy

After you’ve reviewed the policy, verify that you or your loved one meets the benefit triggers. You’ll also want to keep a log of anything that may affect the claim so you can present this documentation if you have any issues. Upon request, your claim papers should arrive within 30 days. Be sure to fill out each and every line accurately – you can also put “not applicable” in certain sections. Once this has been completed, make a copy of it and send the original back to the company. If you decided to fax the paperwork, be sure to call to ensure that the insurance company received it.

Remember, submitting a claim accurately for the first time can be a complex process – especially since you’re new to the process. If you’ve made it this far, you’re likely on the verge of starting the filing process on your own or with a family member. Remember, there is help. At A-1 Home Care Agency, we pride ourselves in being the experts on Long Term Care Insurance. With over 25 years of experience working with clients that have Long Term Care Insurance, we understand what it takes to help file your claim properly. If you’re having trouble filing your claim, feel free to give us call today for a free consultation with one of our claims experts.

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A-1 Home Care Agency is here to provide you with more information, answer any questions you may have, and create an effective solution for all your care needs.