Filing a claim starts with a simple phone call.

Authorization for Disclosure of Information

If you would like to authorize us to speak to a designated person about your coverage, complete and return the Authorization for Disclosure of Information form.

Need more help? Get answers to frequently asked questions about claims.


Filing a Claim

Filing a Claim

To start the claims process, review the eligibility requirements and then call us. When you call, you will reach one of our customer service consultants (CSC), who will explain the process and review the initial information we need from you, including the required forms you must complete and submit to begin your claim.

We are only authorized to speak with you, the policy holder. If you'd like to authorize us to speak with a designated person about your coverage, complete and return the Authorization for Disclosure of Information.

Additional information

To assist us in determining if you're eligible for benefits, a care coordinator may:

  • contact you, your physician, or other persons familiar with your condition
  • access your medical records to get information about your condition or the services provided to you (we cannot approve a claim if we are not given access to your medical records)
  • request to have you examined, at our expense, by a licensed health care practitioner and/or
  • conduct an on-site assessment at your residence by a registered nurse, who is local to your geographic area and employed by our contracted national vendor; the nurse will observe your ability to perform activities of daily living and administer a brief mental status exam

Team of nurses working on your behalf

Our care coordinators are registered nurses experienced in long term care. If your benefit eligibility is approved, we'll assign a team of care coordinators to work with you and your family members to develop a plan of care that meets your individual needs. Our care coordinators can also help you find high-quality care providers in your area; share the results of state survey reports about service availability, quality, costs, and licensing; arrange for discounted services; monitor the care you are receiving; and assist with changing your plan of care as your needs change.

Father and daughter looking at forms online.

Required Forms

If you've reviewed the eligibility requirements and think that you may be eligible for the benefits of your plan, you must complete and return the FLTCIP Claims Initiation Form, Medical Release, and IRS Form W-9. We also need an Authorization for Disclosure of Information form if you would like us to discuss your coverage with another person (including your spouse).

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