Starting the Claims Process:

  1. Call Preferred Long-Term Care (LTC) Customer Service (1-888-331-4188) to complete the Claims Intake Form over the telephone.
  2. Blue Cross and Blue Shield of Alabama will send you a Claims Packet to be completed and returned to us.
  3. A Blue Cross representative from LifePlans will contact you to discuss your initial needs and to clarify any questions you have about your policy.
  4. An assessment will be scheduled and performed by a Blue Cross representative to determine if your situation and health needs meet claims benefit eligibility.
  5. The Blue Cross representative will assist you in developing a Plan of Care - a guide in determining the type and frequency of care services you need.
  6. After determining your benefit eligibility, your Lifetime Waiting Period start date will be determined.
    • Your Lifetime Waiting Period begins after you have been deemed Chronically Ill (or to have a significant Cognitive Impairment) and you have incurred one Qualified Long-Term Care expense.
    • If you use our Care Coordinator services in developing your Plan of Care, and your claim is initiated with Home or Community Services, then your Lifetime Waiting Period will be reduced by half.
  7. Upon completion of your Waiting Period, you will be eligible to begin receiving reimbursement of your benefits.

 

How to file a Claim:

  • You can file your expenses for reimbursement as frequently as you want.
  • Expenses will be applied against your Plan of Care and reimbursed accordingly.
    • For standard policies - all Qualified LTC expenses will be paid in full until you reach your Maximum Monthly Benefit (31 x your Daily Benefit Amount).
    • For Indemnity policies - you will be paid your applicable Daily Benefit Amount.
  • Reimbursement will be sent to claimant; no claims are paid directly to provider.

 

Important Information to Know Before Filing a Claim

  • Power of Attorney (POA) - Blue Cross and Blue Shield of Alabama, or its representatives, cannot discuss your claim in detail with, or send claims reimbursement to, any individual other than the claimant themselves, unless a legal Power of Attorney is provided to us.
  • Be Proactive - if you feel that you may be eligible for claims benefits, contact us as early as possible. It is essential that we are aware of your condition so that we can guide you through the process to ensure you do not make a decision that may adversely affect your ability to maximize your benefits.
  • Do not Wait - Preferred LTC Benefits are reimbursement benefits, and can be filed retroactively should you have already met the Waiting Period triggers. If you feel that you, or your loved one, needs assistance, do not wait to receive that care. Should your situation require an adjustment of services in order to meet Waiting Period or reimbursement requirements, we can assist you with that after you contact us.

 

Important Contact Information

  • Blue Cross and Blue Shield of Alabama Preferred Long-Term Care Customer Service: 1-888-331-4188 or 1-205-733-7019
  • Blue Cross and Blue Shield of Alabama Preferred Long-Term Care Customer Accounts: 1-205-220-4503
  • LifePlans Claims Services:* 1-800-525-7279 extension 273
  • LifePlans Provider Pathway:* 1-800-886-7404 or www.lifeplansproviderpathway.com

 

*Please do not contact LifePlans unless you have already contacted Blue Cross and Blue Shield of Alabama to start your claim.

 

 

 

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