We'll be receiving forms in the mail, have built up considerable benefits. Has anyone been through the certification process, are there any pit falls to look out for? Can assisted living management be of any service?

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There is a different requirement for activities of daily living between states. The AL facility can help you with this. Just be sure before the application is in that your family member has the right requirement in order to receive reimbursement. It doesn't have to be 100% true but it needs to be written correctly in the application. Examples are help with dressing,bathing and medication although I don't know of a facility that does not assume full care of that but maybe that suffices in reporting to the LTC company.

Assume they may drive you nuts at least in the beginning. They may send out notifications that benefits are held up until they have assurance that resident still requires to reside in the facility(as though aging has regressed). Most directors know all about this and are able to provide the information in a timely manner but it helps greatly if the resident has an advocate to help with the process.
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Reply to Riverdale

Do you know what the waiting period is for the LTC policy and the exact date that it started? Some can be 90 days. That might be a first start.

Second could be to make sure whatever “medical condition needed” is covered by their policy. They may need to have their health charts with their primary MD or the medical director affiliated with the AL update all their various health care issues. So even though it’s only AL that they are in, they have enough health issues that makes them eligible to activate LTC coverage.

Then have a clear conversation with billing at the facility as to how they need for LTC claim to be done/ filed so they can be paid. Some facilities totally have it where they do all this for residents in-house and there’s usually paperwork to allow for them to do so on behalf of a resident.

Is it Genworth? Or MetLife or Hancock?
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Reply to igloo572

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