Filing a long term care claim sometimes can be a challenging process. Policies can vary drastically in benefits and claim requirements. Not understanding how the benefits work within your policy and not knowing the proper questions to ask can cause a claim to be delayed or denied.

Below are some helpful questions and things to consider when filing a claim:

• What is the elimination period (usually 0, 30, 60, 90 or 120 days), and is it based on service days or calendar days? (Elimination period is the time frame from when you place a claim to when you receive the benefit.)
• What is the benefit amount that will be paid? Does the benefit amount change based on the service you are receiving? (Some policies might pay a different amount for a nursing home vs. assisted living.)
• What impairments are needed to trigger benefits?
• Are there qualifications that the caregiver needs to meet for the claim to be accepted?
• Does the policy have any limits or exclusions?
• Are there any benefits that are paid at death?
• Does the insurance company require a care coordinator?
• What is the normal time frame to process a claim?
• Who are the benefits paid to?
• Is hospitalization required before filing a claim? (Sometimes in older policies.)
• If home health care is provided, does the caregiver need to keep “daily care notes”?
• Is it an indemnity plan, or a reimbursement plan?

All companies have their own claim forms and processes. Contact them directly, or contact us to help you start your claim.