Definitions

FLTCIP 1.0
The FLTCIP's long term care insurance plan prior to October 1, 2009.

FLTCIP 2.0
The FLTCIP's long term care insurance plan prior to October 1, 2009.

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

 

Meeting Your Waiting Period

Meeting Your Waiting Period

Your waiting period is similar to a deductible in other insurance plans. The length of your waiting period is shown on your current schedule of benefits and is either 30 or 90 days depending on your specific plan. You only have to satisfy your current plan's waiting period once in your lifetime.

If you have a service day waiting period A service day waiting period is the number of days you must be eligible for benefits and receiving and paying for care (approved by your care coordinator) before we'll pay the benefits of your plan. We'll request the following information to help determine when your service day waiting period has been reached.

  • itemized bills and an explanation of what services were provided
  • a completed Informal Caregiver Invoice and proof of payment for services that were provided by an informal caregiver
  • invoices from a formal provider

Services must be paid at the time rendered. Note: Services paid for in cash cannot be validated to count toward the waiting period or be reimbursed.

If you have a calendar day waiting period

A calendar day waiting period is the number of calendar days you must be eligible for benefits before we'll pay the benefits of your plan.

Benefits immediately available to you

The waiting period does not apply while you are receiving hospice care, respite services, caregiver training, or the stay-at-home benefit (if you are enrolled in a FLTCIP 2.0 plan). We'll pay for these services, however, they do not count toward meeting your waiting period (if you have a service day waiting period). If, at any point, you are no longer approved for these services, benefits for other covered services will not be payable until the waiting period is satisfied.

Notification that the waiting period has been met

If your plan of care includes services that are subject to a waiting period, we'll send you written confirmation once you have satisfied the waiting period indicating the date you're eligible for reimbursement of benefits and the date your waiver of premium will begin. Additionally, if you have an online account, it will be updated to indicate that your waiting period has been met.

Waiver of premium

You will not have to pay your premium once you have satisfied your waiting period. We'll also waive your premium if you're eligible for benefits and receiving hospice care. If you satisfy the requirements for the waiver of premium on the first day of a month, the waiver will take effect on that date. Otherwise, the waiver will take effect on the first day of the following month.

To determine what waiting period you have, please refer to your latest schedule of benefits, or view your waiting period and other benefits within your online account.


Image of invoice.

Informal Caregiver Invoice

If you have a service day waiting period and use an informal caregiver, you must submit this form along with proof of payment to satisfy your waiting period before you can be reimbursed for services. Note: Payments made by cash or checks made out to cash are not reimbursable.

Go to Cost of Care Tool.