Your waiting period begins when you become eligible for benefits and incur expenses for long term care. The length of your waiting period is shown on your current schedule of benefits and is either 30 or 90 days depending on your specific plan. You only have to satisfy your current plan’s waiting period once in your lifetime.
A service day waiting period is the number of days you must be eligible for benefits and receiving and paying for care (approved by your care coordinator) before we’ll pay the benefits of your plan. We’ll request the following information to help determine when your service day waiting period has been reached.
- Itemized bills and an explanation of what services were provided
- A completed Informal Caregiver Invoice and proof of payment for services that were provided by an informal caregiver
- Invoices from a formal provider
Services must be paid at the time rendered. Note: Services paid for in cash cannot be validated to count toward the waiting period or be reimbursed.
A calendar day waiting period is the number of calendar days you must be eligible for benefits before we’ll pay the benefits of your plan.
If your plan of care includes services that are subject to a waiting period, we’ll send you written confirmation once you have satisfied the waiting period indicating the date you’re eligible for reimbursement of benefits and the date your waiver of premium will begin. Additionally, if you have an online account, it will be updated to indicate that your waiting period has been met.
You will not have to pay your contribution once you have satisfied your waiting period. We’ll also waive your contribution if you’re eligible for benefits and receiving hospice care. If you satisfy the requirements for the waiver of contribution on the first day of a month, the waiver will take effect on that date. Otherwise, the waiver will take effect on the first day of the following month.
