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Three Steps to Filing Long Term Care Insurance

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Passing The Disability Test


Claimants need to prove that they are cognitively impaired or that they need help performing a few activities of daily living, such as assistance with eating or bathing. A licensed health care provider needs to confirm everything in writing, including all of the details of the patient’s disabilities. It is also recommended that a doctor should create a prescription or suggest home health care throughout the week or nursing home care for the rest of the life of the patient. When contacting the insurer to file the claim, it’s important to make it clear that there is already documentation from the doctor available.


Check Requirements For Caregiver


Before making the decision to hire a caregiver, it’s a good idea to read the policy’s information about the type of aides that the insurance company is willing to cover. Many of the policies that you will encounter will only be willing to pay for licensed caregivers that are working for an agency. It’s important to find out what kind of aide is supported by the policy as this will prevent the possibility of hiring someone that isn’t qualified based on those requirements. The requirements also cover aides during the elimination period, despite the fact that individuals are paying for the care on their own.

Of course, not all states require licenses. For example, in Arizona there is no license requirement for home health aides. It’s important to find out what the laws are in the corresponding state when seeking an aide to hire for care. It’s also a good idea to keep a log of communications with the insurer. Phone calls should be followed up with an email, letter, or fax. If the insurer denies a claim or takes too long handling the claim, then consider hiring a lawyer who is experienced with filing claims against insurance companies.


Determine When Everything Begins


Policies generally include a deductible that is known as an elimination period. They may last 20, 60, or 90 days. Insurers tend to differ on how they count this period. Some policies use calendar days, which means that paying for services 60 days after the claim is filed or after the doctor has certified that you have a covered condition. However, other plans count with the use of service ays, which means that they only count the days that you are paying for a home health aide. For example, if a caregiver is visiting three days out of the week, then the insurer only counts those visits towards the 60 day waiting period. The benefits don’t become available until 20 weeks in these circumstances, which means that the family is responsible for the costs. However, some policies have the elimination period waived for home health care. This is why it’s important to know what is covered in your policy and what isn’t.