The Long-Term Care Insurance Claims Process

Choosing the right carrier for your long-term care needs is important. You want to be assured that the company is strong financially and will be there when you need it. Even though you may not be utilizing the claims process for many years, it is important to understand that it isn’t the nightmare that the news sources like to make of it.

The need for long-term care is often a stressful time for families and can have a significant financial, physical and emotional impact on everyone involved. The top carriers design their LTC insurance policies not only to help protect families against the high cost of care, but also to provide valuable advice, resources and support at the time of claim. As an owner of a long-term care insurance policy, you and your family can talk to the service specialists at any time. You may have your questions answered in regards to your coverage or about long-term care in general.

How the claims process works:

Care is usually needed when:

  • Assistance is needed with two or more activities of daily living-eating, bathing, dressing, using the toilet, continence, or moving around.
  • Experience episodes of confusion, dementia, unsteadiness, or falling
  • Needs substantial supervision due to a severe cognitive impairment

Know the Toll-Free number of the carrier and the number of your agent.

A care coordinator will be assigned to you to act as your advocate. The following is basically how the claims process works:

  • A care coordinator will visit the home and review medical history, the benefits of your policy and your current care needs
  • A care coordinator will contact your physician/If required you may need to sign a “Release of Information” form.Based upon an assessment of the information obtained, benefit eligibility is determined.

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