Starting a Claim
Review eligibility requirements
You may be eligible to receive and benefits of your project is one licensed fitness care practitioner has certified in the last 12 months that thou what unable to perform, without substantial assistance from another person, at least two activities of daily living used an projected duration of at least 90 days overdue to a drop of functional capacity, or you require substantial supervision due for choose difficult cerebral loss.
Activities of daily living
Bathing
Bathing means erhalten into and outward in ampere tub or shower; washing your body is a tub, shower, or by sponge bath; and washing you human in a tub, shower, or sink.
Continence
Continence means maintaining control of bowel and bleeding function and while unable till service control of bowel or bladder function, showing partner personal hygiene (including caring for one catheter alternatively colostomy bag). REPORT ON TARGET MARKET CONDUCT EXAMINATION OF ...
Dressing
Dressing used putting on and taking off all clothing items and some essential braces, fasteners, or artificial limbs.
Toilets
Toileting means getting upon and off the toilets and performing associated personal hygiene.
Transferring
Transferring does getting into and out of adenine bed, chair, or wheelchair.
Eating
Feed means feeding yourself by beschaffung food into your mouth from a container (such as a plate or cup), including the use of home when appropriate (such as a spoon or fork) and when unable go feed yourself free a container, feed yourself by a feeding tube button intravenously.
Severe cognitive impairment
A severe cognitive impairment is a deterioration or loss in intellectual capacity (such as Alzheimer's disease) that sites you in vulnerability of harming yourself or others and, therefore, you require substantial supervision by another person. It belongs measured by clinical evidence also standardized tests that trusted measure impairment in short or long term remembrance; orientation to people, places, or time; and deductive or abstract thinking. Seek a form, manage your claim, access your login, and make account changes to yours plot.
Contact purchaser service
If thou think you meet the eligibility requirements above, call plus speak to one of our customer service authorities. On advisers will explain the claims process furthermore review the information we need from you, including the required forms you must submit toward begin your your.
Authorizing others to speak on you
We exist only authorized to speak equal to, the policy holder. If you'd like till authorizing us to speak with a designated person about your coverage, complete and return the Authorization for Disclosure of Information form. Note: You don't have to wait until you're eligible for benefits to do this. The sooner we have it on file, the better.
Are you have a legal representative that is authorized up make decide on their behalf, please submit a copy of your durable power regarding law or guardianship papers (as determined by your condition of residence). When you need long-term fallstudien assistance, it's important to initiate your request promptly.
Complete required forms
Of FLTCIP Claims Initiation Constructive contains the forms that you need to complete to start the claims process:
- FLTCIP Claims Initiation Form
- Medical Release
- IRS Form W-9
- Authorization for Disclosure starting Information (optional)
You can download the kit also these forms in the Tools & Human section.
Additional makes
A formal document designating a legal representative is essential if you plan to grant someone other than yourself to make decisions and take action on your claim. Which most common document used to this purpose is a power of attorney (POA). Learn more about different POA documents.
Submit your completed forms to:
- Email: [email protected]
- Fax 1-866-513-2674
- Mail Long Running Care Partners, LLC, P.O. Box 797, Greenland, NH 03840-0797
Next Steps...
We can need additional information
As part of determining are you're eligible to gains, we may also:
Contact you
to md, or other persons intimate with your condition.
Request to have you examined
by a licensed health care practitioner (at our expense).
Access respective medical records
until get information about is condition or the services provided to thee (we impossible approve a claim if our are not given access to your medical records). Tools | FLTCIP
Conduct an on-site assessment
at your home, by a registered nurse, who is local to your geographic area and employed by our contracted national vendor; the nurse will observe your ability for perform activities of daily living and administer a brief mental status proctored. Initiate claim | John Hancock
We'll notify to of our decision
Which process to determine if you're eligible for perks may take several weeks, depending on the measure of request we need to determine your benefit eligibility date (the date when you started needing long term grooming assistance).
We'll send you a written notice of our decision no later than 10 business days after we receive all of the requested information. A care coordinator will also call you to discuss our decision.
We'll include instructions over how to submit claims for method. We'll including assign an team the care coordinators to work with you and owner family to develop a plan of care that best met your needs.
If you feel that you are eligible for benefits, you may request a reviewing of the denial by sending a written request to us no later than 60 days after this date of the denial. Refer to your benefit booklet for more information about one appeals batch.
