When a policyholder is identified by a physician as being unable to do two out of six activities of daily living (eating, bathing, dressing, transferring, toileting, continence), or is diagnosed with a cognitive impairment, they are generally eligible for LTCI benefits.
If you’re helping a parent or loved one file an LTCI claim, the claims process may be new to you. Use these four tips to help make the claims filing process a little easier.
1. Gather the Policy Information
Make sure you know where a parent or loved one keeps their policy information or keep a copy for your records. You will need this information in the event they need long term care services and are unable to file a claim themselves.
Find their policy number and any information available before calling their insurance carrier. The claims phone number should be included within the policy or may be found online. If you’re calling for someone else, some insurance companies may require that you be the policyholder’s legal representative or power of attorney.
2. Understand How the Elimination Period Works
After a physician confirms a cognitive impairment or inability to do two out of six ADLs, the elimination period begins. Elimination periods can be 20, 30, 60, or 90 days before benefits are paid.
It’s important to understand the difference between service and calendar day elimination periods. Service day eliminations account for each day you receive long term care services. Calendar day eliminations are based on standard calendar days.
3. Contact the LTCI Claims Customer Service Department
You do not need to satisfy the elimination period before initiating a claim. Call the insurance company immediately or within two weeks of receiving long term care services to initiate a claim. You may be assigned a dedicated case manager to follow your loved one’s care while on claim.
Get answers to any questions about the claims process to understand what you and the policyholder (if applicable) need to do next. Your claim request will then be reviewed by the carrier for eligibility.
4. Keep Your Emotions in Check
Long term care events can be an emotionally challenging time for families. Make a list with your questions and be careful about making big decisions while emotions are high.
Claims customer service representatives understand it’s a difficult and stressful time for families. As you navigate the claims process, you can contact the case manager or carrier claims service center at any time for advice or support.
Long Term Care Insurance offers peace of mind and support for families during stressful times. Chat with an LTC Consumer specialist to learn more about coverage and rates to make sure your future is protected.