Review Your Insurance Policy:

• Locate the insurance policy document or contact the provider to obtain a copy.

• Look for terms related to long-term care, in-home care, skilled nursing, or personal care services.

• Note details such as coverage limits, exclusions, daily or monthly benefit amounts, and waiting periods.

Contact the Insurance Provider:

• Call the customer service number listed on the insurance card or policy.

• Request detailed information about:

  • Coverage for long-term care services.

  • Pre-authorization or prior approval requirements.

  • Required documentation for claims (e.g., invoices, care plans).

Gather Required Information:

• Policyholder’s name and policy number.

• Detailed description of the services required.

• Provider information (e.g., Supplemental Support Care Services).

Check Eligibility for Specific Services:

• Confirm if the care services you need (e.g., in-home care, assisted living) are covered.

• Ask if additional criteria, such as medical necessity, must be met.

Understand Out-of-Pocket Costs:

• Inquire about co-pays, deductibles, or services that may not be covered.

• Determine if supplemental insurance or payment methods are needed.

Request an Explanation of Benefits (EOB):

• An EOB provides a breakdown of what the insurance will cover and any remaining balance for which you are responsible.