IQ expert Dr. Marion Somers: How to file a long-term care insurance claim
Q: If I buy long-term care insurance, how does the claims process work? Is it similar to the claims process for health insurance?
A: No matter what type of insurance claim is involved, most insurance policies provide reimbursement for costs incurred — the policyholder keeps receipts and submits them to the insurance company for payment. Of course, the insurance company first will determine whether the policyholder meets the benefit eligibility triggers that have been set out in the policy.
When filing a long-term care insurance claim, or any insurance claim, here are some steps you should follow:
• Have a copy of your insurance policy on hand, then call the insurance agent who sold you the policy. Let your agent know that you’re ready to tap into the policy’s benefits and that you’d like to review the policy’s terms.
• Be aware of your policy’s predetermined elimination period. During this time, you may have to pay for expenses out of pocket.
• Remember that all appropriate forms must be filled out before an insurance company will act on your claim.
• Keep in mind that all care providers involved may have to submit their records and documentation.
• Hang on to a copy of all correspondence and documents. Take notes regarding people you’ve spoken to and what they said. Jot down times, dates and contact information.
• Keep the lines of communication open with your insurance agent and insurance company. That way, you know how your claim is progressing and whether all of the requested information has been submitted.
Keep in mind that claims sometimes denied or appealed. Try to stay on top of each step as the claim goes through its various stages. If the customer service is not to your satisfaction, you may want to register a complaint with your state insurance department.
Dr. Marion Somers, Ph.D., has more than 40 years of experience as a geriatric care manager and caregiver, and as an author, speaker and teacher regarding elder care and other elder issues. With the senior generation living longer than ever before, Dr. Marion believes we are on the verge of an “elder care tsunami.” After decades of working directly with seniors and their caregivers, Dr. Marion launched a public effort to provide practical tools, solutions and advice to those struggling with caring for our aging population. She is the author of “Elder Care Made Easier: Doctor Marion’s 10 Steps to Help You Care for an Aging Loved One” and creator of two iPhone apps: Elder411 and Elder911.
For more information, visit www.drmarion.com.
If you have a long-term care insurance question for Dr. Marion Somers, please send it to email@example.com.