Should We File Rehab on our Long Term Care Claim?

There is this a bit of confusion about when “long term care” starts. Often it is stated that a person is in long term care when their short term care ends. “Short term” means care from which a person is likely to improve. So often this tends to mean Doctor visits, Hospital stays, and rehab care – the types of care that health insurance and Medicare pays for.

While this is all correct, some contracts for long term care insurance will count the days in a rehab unit towards the initial elimination period (also called a ‘wait window’ – essentially the first number of days the policy holder must pay the full cost of care before the policy will start to pay its share. See other blogs for more explanation of the Elimination Window). So when we are filing a claim here at Mrs. LTC, Inc., we always go ahead and submit the documentation for the rehab stay. If the carrier will count those days then you are that much closer to the claim paying benefit and owe that much less out of your pocket for those first several days.

The carrier may not count the rehab days. But hey! I’d rather file it and find out it did not count, than fail to file the documents if they would have counted! After all a 30 day stay in a rehab that counts towards your elimination period could save you hundreds to thousands of dollars. So it is worth chasing the documents down and getting them to the carrier as part of the claim.

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