LTC Claims Process
Is it time to begin a claim for long-term care insurance benefits? We are here to help. We will outline each step to guide you along the process.
When to consider initiating a Long-Term Care (LTC) claim:
You may consider filing if you:
- Are meeting the benefit eligibility requirements as defined in your policy/plan/certificate, and
- Are receiving long-term care services, or
- Plan to receive long-term care services soon, or
- Recently had long-term care services.
If you meet the criteria above, please click here to view “Initiating a Claim.”
*Please note anyone can initiate a claim on your behalf but, only you or your legal representative will have access to your information. If you have a Power of Attorney acting on your behalf, additional paperwork will be required when submitting your claim to avoid any potential delays.
If the above criteria do not apply to you, it may not be the right time to initiate a new claim. For more information about obtaining a copy of your policy or to discuss your situation, please contact us at 888-687-0977.
What to expect when you initiate your claim
Benefit Intake Process
What we need from you
- Complete Initial Claim Packet
- Submit all necessary legal documentation
What to expect from us
- Benefit Intake Specialist will review information to ensure all needed documents have been received.
- Claim will be assigned to Care Coordinator for evaluation
Benefit Eligibility Review
What we need from you
- Details and timeline of claim for initial call with Care Coordinator
What to expect from us
- Care Coordinator will contact you to review policy and timeline
- Care Coordinator will order applicable records from physicians, care providers, etc.
- Care Coordinator will review all available information to determine eligibility
Eligibility Outcome
- If eligible, Care Coordinator will provide authorization letter and information on how to submit invoices
- If not eligible, Care Coordinator will provide letter and appeal information
- Notify Care Coordinator of any changes to providers or level of care
Claims Reimbursement
What we need from you
- Submit invoices for covered services that have been rendered
- Continue to notify MetLife of any changes in providers, care or level of care
What to expect from us
- Completed invoices will be processed, generally within 10 business days of receipt.