We want to provide you with information and resources for filing a claim for you or your loved ones’ long term care insurance policy.
Below is a general framework of how a claims process works.
- The policyholder or a member of their support team contacts the insurance carrier to obtain a claim form (the telephone number of the carrier is typically listed on the first page of the policy).
- The carrier determines if the policyholder’s care provider meets the policy requirements and notifies the policyholder in writing.
- Before benefits are paid, the elimination period must be satisfied. The elimination period is the number of days the policyholder must pay for service while remaining eligible for benefits, similar to a deductible.
- The policyholder, or a member of their support team, must submit written invoices for covered services in order to receive policy benefits, often on a monthly basis. The policyholder may choose to have the carrier pay all approved long term care expenses directly to the service provider or be reimbursed for qualifying expenses they pay themselves.
- The carrier will review the Long Term Care Insurance claim periodically to ensure the policyholder remains eligible for benefits.
Mutual of Omaha
Another helpful resource is Amada’s Long Term Care Insurance Resource Center. Their free resource center can help you understand your long term care policy, and even help you initiate a long term care insurance claim to get the most out of your Long Term Care Policy.
The information provided is not exhaustive and is intended to provide the general framework for processing a typical long term care claim only.