Empowering Peace of Mind Through Expert Advocacy
Insurance Advocacy
Policyholders are often left on their own to navigate the claims process and better understand their coverage. Without expert help, many struggle to have their claim approved and needs met.
Why an Insurance Advocate Is Essential
Family First’s experienced Insurance Advocates work with caregivers and their families to uncover and resolve insurance challenges, thereby lowering claim costs, improving outcomes and satisfaction. They’ll make sense of your current insurance benefit, gaps in coverage, and advise on how to take advantage of insurance benefits.
Having professional advocate who is knowledgeable about the process and can work within it efficiently and accurately saves time, money, and lowers stress.
Long-Term Care Insurance (LTCi) Claims Advocacy
The Components of an LTCi Claim
Long-Term Care Insurance claims are evaluated on the basis of three sources of information about the policyholder’s caregiving needs. Below are the components and common pitfalls policyholders should be aware of.
A Provider’s “Plan of Care”
Unfortunately, it is rare that providers document care needs in light of the specific triggering criteria that allow collecting of LTCI benefits.
Medical Records
Medical records and self-reporting often lack current and thorough information. Infrequent physician visits compound this problem.
Insurance Carrier Assessment
Insurance companies have the right to independently evaluate the policyholder’s needs. Policyholders can be vulnerable at this time and have the tendency to assert independence beyond their true capacities.
Our Expertise
Medicare & Medicaid
Long-Term Care Insurance
Veterans (VA) Benefits
Medicare Advantage & Supplemental Insurance
Frequently Asked Questions
What does your insurance advocacy service include?
We help individuals and families navigate complex insurance systems by reviewing policies, identifying eligible benefits, assisting with claims, and advocating for approvals—especially for VA benefits, long-term care insurance, Medicaid and Medicare.
Can't I just fill out the claims form myself?
Of course you can! However, keep in mind, that having a long-term care benefits insurance policy does not mandate approval of a claim. There are many forms and components to a claims packet. The process takes patience, know-how, excellent time management, and organizational skills to lead to a successful outcome.
I am trying to make a claim on my mother's LTCi policy for help with her dementia. Can you help?
Absolutely. In general, cognitive impairment needs to be significant enough that policyholders need supervision due to safety concerns for themselves and others. In addition, insurance companies have the right to independently evaluate the policyholder’s needs. Policyholders can be vulnerable at this time and have the tendency to assert independence beyond their true capacities.
If the policyholder denials cognitive decline or asserts independence, that’s a problem. Family First helps interpret policy language, knows what to look for, and offers strategies to avoid denial and anxiety before the insurance assessment.
Can you help file an appeal of a denied claim?
Absolutely. Our LTCi advocates are experts at the claims process and will take the time to review and understand why the claim was denied. If there is any chance the denial could be overturned, we will help you design a formal appeal.
Why should I trust you?
Family First has over 30 years of experience working with clients and their insurance companies. We know how to make the process smooth and successful.
In addition, we have Licensed Counselor, Professional Care Managers, and Home Care providers available to provide additional services that benefit many families who need help with long-term care coverage.
We also want you to have a choice. If you need our help partially or would like to outsource the entire claim process, we are available in whatever capacity you need us.