LTC Eligibility Review Process
A team will be assigned to evaluate your claim. The team will work with you, or your personal representative, and care providers, to gather all required documentation, which may include, among possible others:
- Functional Assessment Interview
- Authorization to Release Information
During the eligibility review process, our team will evaluate the type(s) of Long Term Care (LTC) Benefits you wish to access and the policy or certificate's coverage limits. This team may also consider your medical records, assessment interviews and provider information.
Genworth will make a claims decision after receiving all the required information needed to complete the evaluation process. If additional information is needed, you will receive periodic communication outlining the remaining documentation required to complete the review.
You can help the eligibility review by ensuring Genworth has complete and current information for the insured and/or the authorized representative for the claim (i.e. mailing address and phone number), and by being available for questions.
After reaching a benefit eligibility determination, a member of the team will contact you, or your personal representative, by letter or telephone to discuss the decision made and to answer any related questions.