3 Steps to Take Before Filing a Long-Term-Care Insurance Claim in Florida

3 Steps to Take Before Filing a Long-Term-Care Insurance Claim

Wednesday, March 6, 2019

Insurance companies pay out billions of dollars in benefits annually for long-term senior care insurance claims. Some consumer advocates and lawyers say that many aging adults needing senior care struggle for months, or even years, to have their claims paid.

Insurance companies often find loopholes which allow them to deny claims. It’s essential to know what is covered by a specific policy and what might also prevent it from being paid.

Here are three things you can do now before filing a long-term senior care insurance claim.

  • Know what your deductible or elimination period is. Some policies state 20, 60 or 90 days and some differ on how those days are counted. One policy might use calendar days after the claim is filed and others might use the days after the doctor has certified the need. Another policy may consider “service days”, which would only be the days you’re paying for a home health aide during the waiting period. If you have a 60-day waiting period, a caregiver may have to help with 60 senior care visits before the policy will begin to pay for services. This means the aging adult or the family will have to pick up the tab in the interim period.
  • Be prepared to file quickly. The insurance company will probably request medical records and sometimes even send a nurse or social worker for an assessment before approval of the claim. Get documentation from the physician as soon as possible.
  • Understand the disability test. The aging adult needing senior care will have to prove cognitive impairment or that he or she needs help with two or more activities of daily living (ADL). A licensed healthcare provider must certify in writing that the adult needs help with bathing, eating or other items on their test.

Insurance claims for long-term senior care can be challenging but Concierge Care can help you with this process. Call us today at 888-205-9940 to talk about professional senior care services. We can help you understand the different types of care that can be provided for you or your loved one.

Fill out the form or give us a call 888-205-9940