Authorized FLTCIP Contacts

Calling or acting on behalf of a FLTCIP claimant who has become incapacitated

Long Term Care Partners, LLC, administrator of the FLTCIP, must have a formal document on file designating you as the enrollee's legal representative and authorizing you to take action on their behalf. The most common document used for insurance claims reimbursement and administration purposes is a durable power of attorney. Learn more about powers of attorney >

If a durable power of attorney does not exist and the enrollee is not legally competent to prepare one, you may need to ask a court to appoint you as the enrollee's guardian or conservator. In this case, we require guardianship and/or conservatorship papers (as determined by the enrollee's state of residence).

As a covered entity under the Health Insurance Portability and Accountability Act (HIPAA), we are committed to safeguarding FLTCIP enrollees' identity and health information to ensure their privacy. Refer to the table below to determine what we need on file in order to speak to you or take action on an enrollee's account:

Who we can speak to	What we need on file:	What you are authorized to do:
FLTCIP authorized contact	We require a FLTCIP Authorization for Disclosure of Information form designating you as an authorized contact on the enrollee's account. It must have been signed by the FLTCIP enrollee while they were still competent, or a legal representative authorized to act on their behalf. If the form is signed by an enrollee's legal representative, it must include the documentation that gives them that authority (e.g., a copy of a durable power of attorney).	You can call our Customer Service Center and speak to our consultants about the enrollee's FLTCIP coverage and benefits. This includes demographic, billing and payment, claim, and other related medical information. You are not able to make decisions on behalf of the enrollee or take action on their account without additional documentation (see below).
Attorney in fact	There are different types of powers of attorney. We typically require a durable power of attorney which is a legal document that the enrollee may have prepared while they were legally competent, designating you (as the attorney in fact) to act and make decisions on their behalf, even if they become incapacitated. For the purpose of handling claims reimbursements and payments, we require the power of attorney to also authorize you to handle finances on behalf of the enrollee. Other types of powers of attorney include a durable financial power of attorney and a springing power of attorney. Learn more about powers of attorney >	If we have a power of attorney on file that grants you the appropriate authority, you can: initiate the benefit eligibility process by signing the necessary claims forms on behalf of the enrollee take action on the enrollee's account, including working with us to establish an approved plan of care submit invoices for reimbursement, or assign payment of benefits to certain providers, on behalf of the enrollee
Court appointed guardian and/or conservator	We require guardianship and/or conservatorship papers (as determined by the enrollee's state of residence) appointing you as the enrollee's guardian or conservator. For the purpose of handling claims reimbursements and payments, we require you to have the authority to handle finances on behalf of the enrollee.	If we have guardianship and/or conservatorship papers on file that grant you the appropriate authority, you can: initiate the benefit eligibility process by signing the necessary claims forms on behalf of the enrollee take action on the enrollee's account, including working with us to establish an approved plan of care submit invoices for reimbursement, or assign payment of benefits to certain providers, on behalf of the enrollee

Calling or acting on behalf of a deceased FLTCIP claimant

Once an enrollee is deceased, any power of attorney they may have established is no longer valid. In this case, Long Term Care Partners, LLC, administrator of the FLTCIP, must have a formal document on file designating you as the executor or administrator of the estate in order for you to start a claim on behalf of an enrollee and submit invoices for reimbursement.

Who we can speak to	What we need on file:	What you are authorized to do:
FLTCIP authorized contact	We require a FLTCIP Authorization for Disclosure of Information form designating you as an authorized contact on the enrollee's account. It must have been signed by the FLTCIP enrollee, or their legal representative, and received by us prior to their date of death or signed by the executor of the estate after their death. If the form is signed by an enrollee's legal representative, it must include the documentation that gives them that authority (e.g., a copy of a durable power of attorney, a copy of court appointment as executor or administrator).	You can call our Customer Service Center and speak to our consultants about the enrollee's FLTCIP coverage and benefits. This includes demographic, billing and payment, claim, and other related medical information. You are not able to take action on the enrollee's account without additional documentation (see below).
Executor or administrator of the estate	We require documentation appointing you as the executor or administrator of the enrollee's estate. Examples of acceptable documents include Letters Testamentary, Certificates of Appointment, and Letters of Administration.	If we have documentation on file that grants you the appropriate authority, you can: initiate the benefit eligibility process by signing the necessary claims forms on behalf of the deceased enrollee (if this process was not started while the enrollee was alive) take action on the enrollee's account, including working with us to establish a list of approved providers used to validate any invoices you may submit for reimbursement submit invoices for reimbursement on behalf of the deceased enrollee
Appointed representative in a small estate affidavit	We require documentation showing that you have been authorized to settle the estate of the deceased enrollee without a formal probate process as determined by the enrollee's state of residence.	If we have documentation on file that grants you the appropriate authority, you can: initiate the benefit eligibility process by signing the necessary claims forms on behalf of the deceased enrollee (if this process was not started while the enrollee was alive) take action on the enrollee's account, including working with us to establish a list of approved providers used to validate any invoices you may submit for reimbursement submit invoices for reimbursement on behalf of the deceased enrollee

Disclaimer: This information is not intended to be legal advice or direction and should not be considered as such. We recommend that you consult with an attorney or legal advisor for advice and answers to any legal questions.