LTC Claim Process

LTC Claim Evaluation Process

Genworth Guide to Making a Claim

The Claims Process evaluation contains two steps, the initial assessment and the eligibility review process.

For more information on each procedure click below:

INITIAL ASSESSMENT               ELIGIBILITY REVIEW

Do you have a Reimbursement or Indemnity policy or certificate?
It is important to know the type of policy or certificate you have because the claim’s evaluation and benefit payment process may differ. Enter the first three characters of the Genworth Long Term Care (LTC) policy or certificate in the box below to find out the policy or certificate type.

With a reimbursement policy or certificate, benefit payments are reviewed based on the billing invoices submitted for covered Long Term Care expenses according to a Plan of Care, and then reimbursed up to the policy or certificate’s coverage limits.

Typically, benefit payments are made within 15 business days of receipt of in good order bills. Payments are made directly to you or a Provider designated by an acceptable Assignment of Benefits.

With an indemnity policy, benefit payments are paid in an amount equal to the applicable benefit upon confirmation that you received covered care and services.

Please note: If you purchased a Home and Community Care Rider with your Indemnity policy, benefit payments subject to that Rider are reviewed based on the reimbursement payment process.

Benefit payments are made within the first 10 business days of the month, after we receive required verification of continuous facility confinement. Payments are made directly to you or a Provider designated by an acceptable Assignment of Benefits.

Before Genworth will pay the covered expenses under your claim, it must be verified that your claim meets all the benefit eligibility and long term care provider requirements set forth in the policy/certificate, and satisfies any applicable Elimination Period.

Please note: Genworth no longer sells Indemnity policies.