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U.S. Office of Personnel Management - Ensuring the Federal Government has an effective civilian workforce

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This page can be found on the web at the following url:
http://www.opm.gov/insure/retirees/index.asp?AnswerId=302

Insurance Programs

Retirees or Family Members

Welcome to the insurance services website for Federal retirees and their survivors. Here, you will find various resources to help you and your family make informative choices regarding health, dental, vision, life, and long term care insurance. You can find information about each program by clicking on one of the links below. Each section includes common questions to help guide you to the information you need.

GUIDE ME...

Long Term Care

I don't agree with the way the plan paid my claim. What can I do?

Answer:

You or your representative may request a review of a denied claim by sending a written request to Long Term Care Partners no later than 60 days after the date of the denial. No later than 60 days after the date Long Term Care Partners receives your request, they will send you written notice of their decision.

After requesting the review, you may be entitled to an independent third party review of the denial.  You can read more information about appeals in the Benefit Booklet you received when you were approved for coverage.  You can also read about the appeals process in the Benefit Booklet Online