Common Questions
How do I update my address or phone number?
You may call customer service at (877) 450-5824 to update your address or phone number. You may also submit a signed written request to our claims address at P.O. Box 64913, St. Paul, MN 55164.
What is a third party designee?
A third party designee is a person of your choosing, such as a relative, friend, or trusted advisor, that we will notify if your policy is in jeopardy of lapsing due to nonpayment of premium. You may elect up to three (3) third party designees.
How do I add or remove a third party designee?
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To Add or Remove Designees: Request the required form by contacting customer service. You will need to return the completed form to us with your signature or the signature of your legal representative for processing.
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To Update an Existing Designee’s Information: You or your designee may call customer service. We will verify the caller’s identity before making changes to any information.
Are my benefits eligible for coverage in another state?
Yes. As long as you meet your eligibility for benefits under your policy, you may use the benefits of your policy in any state.
Why did I receive a Form 1099-LTC?
Payments made for long-term care benefits in the preceding year are reported on a Form 1099-LTC. Forms are generally mailed by January 31 of the current year.
General Questions
How do I file a facility claim for the first time?
When filing a claim for the first time, visit How to Submit Claims for Facility Benefits for detailed instructions.
What documentation do I need to support ongoing facility claims?
Please submit documentation of services provided that are covered in your policy. You can find more information about what documentation is needed for ongoing claims by contacting customer service.
Are my benefits eligible for coverage in another state?
Yes. As long as you meet your eligibility for benefits under your policy, you may use the benefits of your policy in any state.
Why did I receive a Form 1099-LTC?
Payments made for long-term care benefits in the preceding year are reported on a Form 1099-LTC. Forms are generally mailed by January 31 of the current year.
What claim forms must be completed for every facility claim?
The required forms are included within the Claim Information Package. Complete the first two pages of the Policyholder Claim form and the Authorization for Use of Health-Related Information. If the policyholder wants to authorize other individuals to speak with us about a claim, please also complete the Authorization For Disclosure of Health-Related Information. All forms should be submitted to us together, including itemized invoices.
Is there any additional information, other than claim forms, needed to make a claim determination?
Once we receive completed claim forms, it may be necessary for us to obtain additional documentation to make an accurate determination of eligibility for benefits. The additional documentation may include, but is not limited to, physician and hospital records, the provider’s license (if applicable), and care provider notes. In all cases, itemized bills must be submitted for benefits to be provided. It is very important to make copies of all correspondence and documentation submitted for your records. Please refer to How to Submit Claims for Facility Benefits for detailed guidance on completing the claim forms, as well as additional documentation that may be needed.
Who completes the claim forms?
The policyholder or legal representative will complete the Policyholder Claim form and the Authorization For Use of Health-Related Information. The policyholder or legal representative will also complete the Authorization for Disclosure of Health-Related Information if you want to authorize us to speak to anyone other than the policyholder about this claim. Be sure to return these documents to us at the same time.
What is a Continued Monthly Residence ("CMR") Form?
A Continued Monthly Residence form is a required part of the monthly claim submission and must be completed thoroughly by facility staff.
How do I arrange for my care provider to be paid directly?
Complete and submit a Direction to Pay form to arrange for your care provider to be paid directly. This form is required only if you want to arrange for direct provider payment. In addition, your provider must send us a completed W-9 form (required by the IRS). This is not a permanent assignment of policy benefits. Should you decide to cancel the direct pay arrangement, please send a written request to P.O. Box 64913, St. Paul, MN 55164.
Where can I get additional claim forms?
Additional claim forms can be downloaded from our Forms page or you can call our customer service team to obtain forms through the mail.
Who can answer questions or concerns about the status of a claim or the claim process?
A member of our customer service team can clarify policy benefits and explain the claim process, although some privacy regulations may apply. If you have questions regarding a claim, please contact us.
Where should I send the completed claim forms?
The claim forms should be mailed to P.O. Box 64913, St. Paul, MN 55164. Alternatively, the claim forms can be sent via fax to (952) 983-5256.
Questions about Facility Claims
How do I file a home health care claim for the first time?
When filing a claim for the first time, visit How to Submit Claims for Home Health Care Benefits for detailed instructions.
What documentation do I need to support ongoing home health care claims?
Please submit documentation of services provided that are covered in your policy. You can find more information about what documentation is needed for ongoing claims by contacting customer service.
Are my benefits eligible for coverage in another state?
Yes. As long as you meet your eligibility for benefits under your policy, you may use the benefits of your policy in any state.
Why did I receive a Form 1099-LTC?
Payments made for long-term care benefits in the preceding year are reported on a Form 1099-LTC. Forms are generally mailed by January 31 of the current year.
What claim forms must be completed for every home health care claim?
The required forms are included within the Claim Information Package. Complete the first two pages of the Policyholder Claim form and the Authorization for Use of Health-Related Information. If the policyholder wants to authorize other individuals to speak with us about a claim, please also complete the Authorization For Disclosure of Health-Related Information. All forms should be submitted to us together, including itemized invoices. The Caregiver Weekly Timesheets may be used if your provider does not supply them.
Is there any additional information, other than claim forms, needed to make a claim determination?
Once we receive completed claim forms, it may be necessary for us to obtain additional documentation to make an accurate determination of eligibility for benefits. The additional documentation may include, but is not limited to, physician and hospital records, the provider’s license (if applicable), and care provider notes. In all cases, itemized bills must be submitted for benefits to be provided. It is very important to make copies of all correspondence and documentation submitted for your records. Please refer to How to Submit Claims for Home Health Care Benefits for detailed guidance on completing the claim forms, as well as additional documentation that may be needed.
Who completes the claim forms?
We request that the policyholder or legal representative fully complete the Policyholder Claim form and the
Authorization For Use of Health-Related Information. The policyholder or legal representative should also complete the Authorization for Disclosure of Health-Related Information if you want to authorize us to speak to anyone other than the policyholder about this claim. Be sure to return these documents to us at the same time.
How do I arrange for my care provider to be paid directly?
Complete and submit a Direction to Pay form to arrange for your care provider to be paid directly. This form is required only if you want to arrange for direct provider payment. In addition, your provider must send us a completed W-9 form (required by the IRS).
This is not a permanent assignment of policy benefits. Should you decide to cancel the direct pay arrangement, please send a written request to P.O. Box 64913, St. Paul, MN 55164.
Where can I get additional claim forms?
Additional claim forms can be downloaded from our Forms page or you can call our customer service team to obtain forms through the mail.
Who can answer questions or concerns about the status of a claim or the claim process?
A member of our customer service team can clarify policy benefits and explain the claim process, although some privacy regulations may apply. If you have questions regarding a claim, please contact us.
Where should I send the completed claim forms?
The claim forms should be mailed to P.O. Box 64913, St. Paul, MN 55164. Alternatively, the claim forms can be sent via fax to (952) 983-5256.
Questions about Home Health Care Claims
Why have I not received a premium notice?
Premium notices are mailed 20 days before the premium due date for policyholders who are not paying by electronic funds transfer (“EFT”). If you do not receive your premium notice in a timely manner, it may be a delay due to postal issues or we may need to confirm from you that we have your correct information on file. You may call customer service at (877) 450-5824 to update your address or submit a signed written request to:
Senior Health Insurance Company of Pennsylvania (In Rehabilitation)
P.O. Box 64913
St. Paul, MN 55164
Do you accept credit card payments?
Currently, Senior Health Insurance Company of Pennsylvania (In Rehabilitation) does not accept credit card payments.
Where do I send my premium payments?
Please send premium payments to:
Senior Health Insurance Company of Pennsylvania (In Rehabilitation)
Dept CH 14356
Palatine, IL 60055-4356
Is there an overnight premium payment address?
Please send premium payments via overnight mail to:
Senior Health Insurance Company of Pennsylvania (In Rehabilitation)
Attn: 14356
5505 N. Cumberland Ave. Ste. 307
Chicago, IL 60656
What is a third party designee?
A third party designee is a person of your choosing, such as a relative, friend, or trusted advisor, that we will notify if your policy is in jeopardy of lapsing due to nonpayment of premium. You may elect up to three (3) third party designees.
Questions about Premiums
How to Report Suspected Fraud
How can I report suspected fraudulent activity regarding a
Senior Health Insurance Company of Pennsylvania (In Rehabilitation) policy?
Insurance fraud costs the United States over $300 billion annually and is one of the costliest white-collar crimes in the United States. It is a crime we all pay for through higher insurance premiums, medical care costs, and law enforcement expenses. While SHIP closely monitors for possible fraud, waste, and abuse, you can help by reporting suspicious activity in one of three ways:
Please call (888) 387-5824
Please write to:
Senior Health Insurance Company of Pennsylvania (In Rehabilitation)
P.O. Box 64913
St. Paul, MN 55164