How to Make a Long-Term Care Insurance Claim

How to Make a Long-Term Care Insurance Claim - Different companies may impose specific conditions on how their policyholders may file a claim. Generally, though, this is how the claiming process goes.

Go over your long-term care insurance policy and check how long your elimination period is and what services it actually covers.

Long-Term Care Insurance Claim

Elimination period is the duration that you have the wait before your policy starts paying off. Apart from knowing how long it will last, you need to also determine if your policy counts service or calendar days against your waiting period. This will give you a picture of how much you will have to pay out of pocket before your policy shoulders your bill.

Likewise, see what services your plan will pay for. Determine which care settings are covered. For instance, will it shoulder for care administered in the home? If so, does it require that the services you receive come from licensed caregivers?

Reviewing these areas of your policy will avoid discrepancies as you make a claim. If your care expenses are in-lined with what your policy will pay for, you can expect no delays in the claiming process.

Call the insurance company
Even if your elimination period is not yet over, it is best to call your insurer once a need arises. Remember that the company will have to go through your records and plan of care before it pays off claims. The evaluation process takes time. That’s why it’s best that you inform them ahead of time.

When you call the company, they will give you guidelines and instructions on how you will file a claim. If you want the process to be smooth, make sure that you follow the steps accordingly.

Submit the required documents
Before your claim will be processed and evaluated, you will need to submit certain documents to your insurer. Typically, the company will ask for:

• a completed claim form 
• plan of care 
• notes and recommendations from your physician and care provider 

If you’re a holder of a reimbursement policy, you will also be required to submit the following

• receipts 
• invoices 
• bills 
• other proof of payment 

To avoid any delays, make sure that you accomplish all of the necessary paperwork. This can be a daunting task; however, the key to a successful claims process is being organized. Keep track of everything including any form of communication that you had with the insurer. Store all the important pieces of paper in one place. This way, you can easily access all the necessary information should you need to track down a conversation or refer to a document.

After you submitted the required documents, the company will evaluate your eligibility. If your insurer deemed that the paperwork you provided is still insufficient, they may request additional information from you.

Important tips
As soon as your policy takes effect, it’s essential that you let your family and loved ones know that you have long-term care insurance. Should you become unable to file a claim personally, a family member can go over the claiming process for you.

Meanwhile, care coordinator services may be offered by your insurer or already tailored in your policy. We suggest that you take advantage of this. The claims process can be an arduous process, but a care coordinator can relieve some of your burden. They can assess and create a care plan for you and look for care providers that are suited for your required level of care. (Logic insurance article source: LTC Options) 

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