first-time-claims

Submitting Claims

First Time Claims

At Senior Health Insurance Company of Pennsylvania (SHIP), we understand that filing a new long term care insurance claim can be confusing. To provide clarity in filing a new claim, the claim information package is designed to provide you with straightforward instructions on how to file a claim under your Senior Health Insurance Company of Pennsylvania long term care policy.

Nursing Home:

When preparing to submit a claim toward your long term care insurance policy, please refer to your actual policy to help determine the type of coverage you have.

In order for an eligibility determination to be completed the following documents are typically required to substantiate Proof of Loss for an insured confined to a nursing home:

Some or all of the following documents may be required to substantiate Proof of Loss for an insured confined in a nursing home. The requirements may vary dependent upon several factors such as, but not limited to, the claimant's primary diagnosis and other medical conditions. The following information may be requested by our claims department to assist in the eligibility determination process.

Assisted Living Facility

When preparing to submit a claim toward your long term care insurance policy, please refer to your actual policy to help determine the type of coverage you have.

In order for an eligibility determination to be completed the following documents are typically required to substantiate Proof of Loss for an insured confined to a nursing home:

Some or all of the following documents may be required to substantiate Proof of Loss for an insured whose primary residence is an assisted living facility. The requirements may vary dependent upon several factors such as, but not limited to, the claimant's primary diagnosis and other medical conditions. The following information may be requested by our claims department to assist in the eligibility determination process:

Home Health Care

These documents are typically required to substantiate Proof of Loss for a claimant receiving or needing home health care:

Some or all of the following documents may be required to substantiate Proof of Loss for an insured who is receiving or needing home health care. The requirements may vary dependent upon several factors such as, but not limited to, the claimant's primary diagnosis and other medical conditions. The following information may be requested by our claims department to assist in the eligibility determination process:

Other Services

(i.e., Adult Day Care, Hospice, Respite, etc.)

These documents are typically required to substantiate Proof of Loss for an insured who files a claim under the policy for ancillary or limited services:

Some or all of the following documents may be required to substantiate Proof of Loss for an insured who files a claim under the policy for ancillary or limited services. The following information may be requested by our claims department to assist in the eligibility determination process: