LTCI Claim Checklist

Long-Term Care Insurance Claim Checklist

Starting a Long-Term Care Insurance (LTCI) claim can feel overwhelming—especially when you’re already worried about a loved one’s safety and care needs. To make things easier, we’ve created a simple, step-by-step checklist you can print and use as you move through the process.

This checklist is designed to help you gather the right information, ask the right questions, and stay organized from your very first phone call to the insurance company through getting care started at home.

Need help with this process?
Assisting Hands Home Care of Chattanooga can review your policy, communicate with the insurance company, and provide the documentation they need once care begins. That way, your family can focus on your loved one—not the paperwork.

How This Checklist Helps

Families often aren’t sure where to begin with Long-Term Care Insurance. However, a clear plan makes the process much less stressful. Long-Term Care Insurance Claim Checklist

Use this checklist to:

Understand what most LTCI companies will ask for
Keep track of forms, contacts, and deadlines
Coordinate between your family, your doctor, and your home care agency
Avoid delays so your benefits can start as soon as possible

You can print the checklist below and write directly on it, or keep it open on your phone or computer and check off each step as you go.

Printable LTCI Claim Checklist

Policy Information

Before anything else, gather the basic policy details. This information will be needed on nearly every call.

□ Locate your LTCI policy (paper copy or digital)
□ Write down the insurance company name
□ Write down the policy number
□ Write down the customer service / claims phone number
□ Note the policyholder’s full name (the person insured)
□ Note the date of birth of the policyholder

Prepare Before You Call

Taking a few minutes to prepare ahead of time can make your first call much more productive.

□ Confirm the current diagnosis or condition (for example: dementia, stroke, Parkinson’s, recent surgery, general frailty)
□ Make a list of daily activities the policyholder needs help with, such as:

Bathing
Dressing
Toileting
Transferring (getting in/out of bed or chair)
Eating
Walking / mobility

□ Note any safety concerns (falls, wandering, confusion, nighttime issues)
□ Gather contact information for:

Primary care doctor
Any specialists
Your preferred home care agency (Assisting Hands Home Care of Chattanooga)

Step 1: Call the Insurance Company

Once you have the basics ready, you can start the claim.

□ Call the claims or customer service number listed on the policy
□ Ask to start a new Long-Term Care Insurance claim
□ Write down:

Date and time of your call: ____________________
Name of the representative you spoke with: ____________________
Any claim reference number they give you: ____________________

During the call, it helps to ask clear, direct questions:

□ Ask the representative:

“What are the steps to start a claim?”
“What forms do we need to complete?”
“Who needs to complete the forms (doctor, family, care provider)?”
“Do you require an assessment by a nurse or care manager?”
“How many Activities of Daily Living (ADLs) must be impacted to qualify?”
“Is cognitive impairment (like dementia) covered?”

Step 2: Understand Your Benefits

Next, you’ll want to understand exactly what your policy covers so you can plan care and costs.

* Inquire about your elimination period (waiting period before benefits begin)

Number of days: __________
Does the elimination period require paid services, or is it based on calendar days?

– Ask about home care coverage specifically:

“Does this policy cover non-medical home care / custodial care?”
“Is there a minimum number of hours per day or week?”
“Are there any agency requirements (licensed, bonded, etc.)?”

+ Write down your benefit details:

Daily or weekly benefit amount: ____________________
Maximum benefit period (e.g., 2 years, 3 years, etc.): ____________________
Lifetime maximum benefit amount: ____________________

Step 3: Complete Required Forms

After your initial call, most companies will send forms. At this stage, organization makes a big difference.

□ Receive claim forms (by mail, email, or online portal)

□ Policyholder / family statement
□ Physician statement or Plan of Care
□ Authorization to release medical information
□ Provider or agency forms, if required

□ Schedule an appointment with the doctor (or ask the office) to complete their portion
□ Coordinate with your home care agency (Assisting Hands) to provide:

A proposed care plan
Service agreement or estimate of hours

Finally, keep good records:

□ Make copies or save digital scans of all completed forms before sending

Step 4: Assessment (If Required)

In many cases, the insurance company may send a nurse or care manager to evaluate your loved one.

□ Confirm whether the insurance company will send a nurse or care manager for an assessment
□ Schedule the visit and write down the date/time: ____________________

To prepare for the assessment:

□ Be honest about what your loved one cannot do safely on their own
□ Share any recent falls, hospitalizations, or confusion episodes
□ Have your list of ADLs and safety concerns ready

□ After the assessment, write down any notes or next steps given to you

Step 5: Choose and Start with a Home Care Agency

Once the claim is underway, you can move forward with getting help in place at home.

□ Contact Assisting Hands Home Care of Chattanooga
□ Share your LTCI policy details with the agency
□ Ask if the agency can:

Help with care notes and documentation
Submit invoices directly to the insurance company (if allowed)
Help you track hours and services for the elimination period

□ Finalize your schedule of care (days, times, and level of support)
□ Sign the service agreement and confirm the start date for care

Step 6: Submitting Claims & Getting Reimbursed

After care begins, you’ll need a routine for sending claims and tracking payments.

□ Confirm whether the insurance company pays:

You (the policyholder/family), or
The home care agency directly

□ Ask how often to submit claims (weekly, biweekly, monthly)

To stay organized:

□ Keep copies of:

All invoices
All care notes / timesheets
Any letters or emails from the insurance company

□ Mark a reminder to follow up if you don’t receive a decision or payment within the time frame they gave you

Step 7: Ongoing Review & Updates

Even after the claim is approved, needs may change over time.

* Keep a folder (paper or digital) with:

Policy documents
Claim numbers & contact names
Copies of all forms, assessments, and letters

– Notify the insurance company if:

The care needs increase
The schedule changes significantly
There is a hospital stay or major health change

+ Periodically review remaining benefits with the insurance company so you know:

How much benefit is left
How long coverage is expected to last at your current level of care

We Can Walk Through This With You

You don’t have to figure this out alone. Our team at Assisting Hands Home Care of Chattanooga regularly works with families using Long-Term Care Insurance to pay for care at home.

If you’d like help reviewing your policy, coordinating with the insurance company, or creating a care plan that fits your benefits, contact us today. We’re happy to walk through this checklist with you and make the process as smooth as possible.