Hiring an Insurance Advocate to represent you or your loved ones may be the best insurance you can buy

Family First's experienced Insurance Advocates work with caregivers and their families to uncover and resolve insurance challenges, thereby lowering claim costs, improving outcomes and satisfaction. They'll make sense of your current insurance benefit, gaps in coverage, and advise on how to take advantage of insurance benefits.

Having professional advocate who is knowledgeable about the process and can work within it efficiently and accurately saves time, money, and lowers stress.

Insurance advocate advising a client

Our Expertise

Medicare & Medicaid

Medicare Advantage & Supplemental Insurance

Long-Term Care Insurance

Veterans (VA) Benefits

Long-Term Care Insurance (LTCi) Claims Advocacy

Your loved one has been paying premiums all these years, and yet when the time comes to reap the benefits, many are denied or under-compensated.

Our Long-Term Care Insurance (LTCi) Advocates are experts in the claims process. They will collect medical records, organize claims packets, and work alongside providers, home care agencies, attorneys, and others to ensure caregiving needs are reflected in a manner necessary to approve the claim.

A Claims Advocate consulting a client

The Components of an LTCi Claim

Long-Term Care Insurance claims are evaluated on the basis of three sources of information about the policyholder’s caregiving needs. Below are the components and common pitfalls policyholders should be aware of.

Unfortunately, it is rare that providers document care needs in light of the specific triggering criteria that allow collecting of LTCI benefits.

Medical records and self-reporting often lack current and thorough information. Infrequent physician visits compound this problem.

Insurance companies have the right to independently evaluate the policyholder’s needs. Policyholders can be vulnerable at this time and have the tendency to assert independence beyond their true capacities.

Frequently Asked Questions

Of course you can! However, keep in mind, that having a long-term care benefits insurance policy does not mandate approval of a claim. There are many forms and components to a claims packet. The process takes patience, know-how, excellent time management, and organizational skills to lead to a successful outcome.

Absolutely. In general, cognitive impairment needs to be significant enough that policyholders need supervision due to safety concerns for themselves and others. In addition, insurance companies have the right to independently evaluate the policyholder’s needs. Policyholders can be vulnerable at this time and have the tendency to assert independence beyond their true capacities.

If the policyholder denials cognitive decline or asserts independence, that's a problem. Family First helps interpret policy language, knows what to look for, and offers strategies to avoid denial and anxiety before the insurance assessment.

Absolutely. Our LTCi advocates are experts at the claims process and will take the time to review and understand why the claim was denied. If there is any chance the denial could be overturned, we will help you design a formal appeal.

Family First has over 30 years of experience working with clients and their insurance companies. We know how to make the process smooth and successful.

In addition, we have Licensed Counselor, Professional Care Managers, and Home Care providers available to provide additional services that benefit many families who need help with long-term care coverage.

We also want you to have a choice. If you need our help partially or would like to outsource the entire claim process, we are available in whatever capacity you need us.

THOUGHT LEADERSHIP

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