LTC Claims Process

Is it time to begin a claim for long-term care insurance benefits? We are here to help. We will outline each step to guide you along the process.

When to consider initiating a Long-Term Care (LTC) claim:

You may consider filing if you:

If you meet the criteria above, please click here to view “Initiating a Claim.”

*Please note anyone can initiate a claim on your behalf but, only you or your legal representative will have access to your information. If you have a Power of Attorney acting on your behalf, additional paperwork will be required when submitting your claim to avoid any potential delays.

If the above criteria do not apply to you, it may not be the right time to initiate a new claim. For more information about obtaining a copy of your policy or to discuss your situation, please contact us at 888-687-0977. 

What to expect when you initiate your claim

Benefit Intake Process

Benefit Intake Process

What we need from you

What to expect from us

  • Benefit Intake Specialist will review information to ensure all needed documents have been received.
  • Claim will be assigned to Care Coordinator for evaluation
 
Benefit Eligibility Review

Benefit Eligibility Review

What we need from you

  • Details and timeline of claim for initial call with Care Coordinator

What to expect from us

  • Care Coordinator will contact you to review policy and timeline
  • Care Coordinator will order applicable records from physicians, care providers, etc.
  • Care Coordinator will review all available information to determine eligibility
 
Eligibility Outcome

Eligibility Outcome

  • If eligible, Care Coordinator will provide authorization letter and information on how to submit invoices
  • If not eligible, Care Coordinator will provide letter and appeal information
  • Notify Care Coordinator of any changes to providers or level of care
 
Claims Reimbursement

Claims Reimbursement

What we need from you

What to expect from us

  • Completed invoices will be processed, generally within 10 business days of receipt.