Have Questions?Long-Term Care Insurance
Consultation & Claims Support
You’ve paid into that policy for years. We help you use it.
If your loved one has a long-term care insurance policy, it can cover a significant portion of their home care costs, but navigating the claims process is confusing and time-consuming. We handle it for you. From verifying benefits to submitting invoices directly to the carrier, we guide families through every step so you can focus on what matters most.
Most Long-Term Care Policies
Cover Home Care
Most long-term care insurance policies cover home care services when a person needs help with two or more Activities of Daily Living (ADLs) such as bathing, dressing, grooming, eating, or mobility, or has a cognitive impairment like Alzheimer’s or other types of dementia.
If that sounds like your situation, there’s a good chance benefits are available. We’ll help you find out.
Common qualifying needs:
- Bathing & personal hygiene
- Dressing & grooming
- Eating & nutrition
- Mobility & transferring
- Toileting & continence
- Cognitive impairment (Alzheimer’s, dementia)
Two or more ADLs, or a cognitive impairment, typically qualifies. We’ll review your specific policy to confirm.
How We Help
We handle the insurance process end-to-end, so families can focus on care — not paperwork.
In-Depth Policy Review
We call both the client and their insurance carrier to walk through the long-term care policy in detail, including verifying benefits, riders, and the specific requirements that need to be met to access coverage. We make sure you fully understand what you have before anything else happens.
Care Plan Development
After a home assessment and policy review, we build a care plan to fulfill the needs of your loved ones. The care plan is a key document required by some insurance carriers. Our agency will also provide the necessary home care services to satisfy the elimination period.
Nurse Assessment Support
Many carriers require a nurse assessment before approving a claim. We prepare families for what to expect and help them navigate the process from start to finish.
Document Collection
We help families gather the right medical records, physician statements, and supporting documents from healthcare providers so the claim submission is complete and accurate the first time.
Claim Submission & Follow-Up
We support families through submitting their claim and follow up directly with the insurance carrier to make sure it’s reviewed in a timely manner.
Assignment of Benefits (Direct Billing)
Where the policy allows, we bill the insurance carrier directly through assignment of benefits, so families aren’t paying out of pocket and waiting for reimbursement.
Ongoing Claims Management
We handle the ongoing documentation, invoicing, and carrier communication required to keep benefits flowing without interruption.
Carriers We Work With
We have experience filing claims with major long-term care insurance carriers. Every carrier has different requirements, and we know how to navigate them.
What Families Ask Most
What is an elimination period?
It’s like a deductible measured in days, not dollars. Most policies require 30, 60, or 90 days of qualifying care before benefits begin paying out. Importantly, care typically must be provided during the elimination period. In many cases, the claim can only be approved after that period has been completed and documented. We help you track and record this correctly from day one.
Can we start care before the claim is approved?
In most cases, yes, and in fact, most policies require it. Care often needs to be in place and documented during the elimination period before a claim can be approved. Our agency provides the home care services to satisfy the elimination period, and we continue delivering care seamlessly once the claim is approved. We make sure everything is set up and recorded properly so there are no surprises.
My claim has been submitted. Why is it still pending?
Carriers can take time to review claims, and they often request additional documentation along the way. We follow up on your behalf to keep things moving and respond quickly to any carrier requests so your approval isn’t delayed. If you started a claim and it is still pending, we are happy to support you in the resolution of that claim.
What documents does the carrier need?
Every carrier is different, but most require physician statements, functional assessments, and care records. We help you collect the right documents from your healthcare providers so nothing is missing from your submission.
Why families trust us
“Most home care agencies leave families to figure out the insurance process on their own.
We don’t.”
We’ve helped families navigate the claims process with major carriers, and we treat the paperwork as part of the care, because reducing your stress is part of our job.
- We call the carrier for you
- We document the elimination period correctly
- We submit and follow up on the claim
- We bill directly where the policy allows
- We keep benefits flowing without interruption
The Qualicare 360° Approach to LTC Insurance
You’ve got a lot of difficult decisions to make. Making this call shouldn’t be one of them.
Find care near your loved one
Discuss your loved one’s needs with your local Care Expert.
Get a plan that works for your family.
After a free, in-home consultation, we’ll create a custom care plan to meet your loved one’s specific needs at home.
Take a breath. Day or night, you’re never alone.
As part of your team, we’re proactively thinking about your loved one’s evolving needs and we’re always here if you need us.
We cover all your needs:
Request a Free LTC Insurance ConsultationFind out what your policy covers — at no cost to you.
Contact us and we’ll review your long-term care insurance policy and let you know exactly what benefits are available for home care services.
The review is free. The help is real.
Request a Free LTC Insurance Consultation
Qualicare is not an insurance company or broker. We assist families in understanding and accessing home care benefits under existing long-term care insurance policies.