About Long-Term Care Insurance Claims

Long-term care can be a very sensitive topic, with even more complications arising when discussing long-term care insurance. Whether you or a loved one is placed in a nursing home, an assisted living facility, or receiving in-house care, there are many factors in long-term care insurance policy coverages. Fundamentally, there are several ways in which your insurance company could deny your claim.

For example, although you may be approved for specific treatments and services, your claim may be denied because you are approved for a nursing home but the facility in question is technically referred to as an assisted living facility or vice versa. Minute details can make all the difference in the outcome of your long-term care insurance claim.

Another claim denial comes when the policyholder is considered no longer cognitively capable and the medical services being received are no longer necessary. These type of denials tend to be very fact-based and/or policy-intensive. Sometimes an expert is needed.


The Difference Between an Assisted Living Facility and a Nursing Home

Understand that your long-term care insurance policy may differentiate between a nursing home and an assisted living facility. Many claim denials arise from this distinction. Although both types of facilities provide care, the insurance company might work against you with that technicality.

These denials are common and can result in thousands of dollars coming out of your pocket weekly. Check what kind of facility or home your policy affords coverage for to avoid this issue. Be careful when exploring a facility for care.


Ease the Billing Process

We are willing and able to work with both the long-term care insurance policyholder and those with assigned benefits. The nursing home or the assisted living facility can work with Merlin Law Group to keep their client and have the insurance pay so they don’t have to kick out the client receiving care. Intake analysis is always free at Merlin Law Group and we would be happy to offer our services and answer any questions you may have.


Need More Information?

If your long-term care insurance claim has been denied, delayed or underpaid, contact Merlin Law Group today for a free consultation.

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