Assignment of Benefits for Long-Term Care Insurance
What is an Assignment of Benefits for Long Term Care Insurance?
An Assignment of Benefits (AOB) for long-term care insurance is a legal arrangement that allows a policyholder to authorize a licensed home care agency to bill the insurance company directly for covered services, eliminating the need for the client or family to pay upfront and seek reimbursement. This streamlined billing process helps families avoid the stress and delay often associated with submitting claims, while ensuring care can begin without financial barriers. AOB is especially valuable for seniors receiving home health aide services, personal care, or live-in care, as it reduces out-of-pocket costs and administrative burden. At 7 Day Home Care, we work directly with all major long-term care insurance providers—including American Heritage, Brighthouse, CNA, Genworth, John Hancock, Lincoln Financial, Mutual of Omaha, New York Life, Northwestern Mutual, NYSUT-HealthSmart, and UNUM—to verify policy benefits, complete all necessary documentation, and manage the entire claims process, allowing families to focus on what matters most: high-quality, uninterrupted care at home.
What Is an Assignment of Benefits (AOB) in Long-Term Care Insurance?
An Assignment of Benefits (AOB) is a legal agreement that allows a long-term care (LTC) insurance policyholder to authorize a home care agency to bill the insurance company directly for covered services. This means the insurance company pays the agency, not the individual receiving care, which simplifies the process and reduces financial burden on families.
With an AOB in place, families do not need to pay out of pocket and wait for reimbursement. Instead, the agency is reimbursed directly by the insurance provider. This system is widely used in healthcare, especially in home care settings, and can be a critical tool for families who need help managing care and finances.
Why Assignment of Benefits Matters
Many families face delays in care due to the administrative burden of paying first and waiting for reimbursement. An AOB solves that by:
- Eliminates the stress and complexity of managing long-term care insurance claims on your own
- Allowing care to begin more quickly
- Reducing or eliminating upfront costs
- Simplifying claims processing
- Minimizing billing errors
At 7 Day Home Care, we help families take full advantage of AOB by managing all communication and paperwork with the insurance company.
How Assignment of Benefits Works: Step-by-Step
Step 1: Policy Review
Our team reviews the client’s long-term care insurance policy to verify AOB eligibility and coverage terms.
Step 2: Authorization Form
We provide an AOB authorization form that the policyholder or their legal representative signs.
Step 3: Care Begins
Once the AOB is in place and benefits are verified, home care services can begin immediately.
Step 4: Billing & Payment
7 Day Home Care submits invoices directly to the insurance company and manages the claims process. Families receive all documentation and are kept informed but will not be burdened with the day-to-day administration of the insurance claim.
What Services Are Covered Through Assignment of Benefits?
While coverage depends on the specific policy, the most common services covered by long-term care insurance with AOB include Activities of Daily Living.
Activities of Daily Living (ADLs) are the basic, routine tasks that people perform every day to take care of themselves. In the context of long-term care insurance and home care services, ADLs are essential because eligibility for benefits often depends on a person's inability to perform two or more ADLs without assistance. Understanding ADLs helps families and caregivers assess the level of support a loved one may need at home.
The Six Primary Activities of Daily Living (ADLs):
- Bathing
The ability to bathe oneself safely and maintain personal hygiene, including showering, washing hair, and oral care. - Dressing
The ability to choose appropriate clothing and put it on or take it off without help. - Toileting
The ability to get to and from the toilet, use it appropriately, and manage personal hygiene afterward. - Transferring
The ability to move from one position to another—for example, from a bed to a chair or from sitting to standing. - Continence
The ability to control bladder and bowel function or manage incontinence hygiene products independently. - Feeding
The ability to feed oneself, not including meal preparation—just the act of eating or drinking.
Why ADLs Matter in Long-Term Care
Long-term care insurance providers use ADLs as a standard measure to determine whether a person qualifies for benefits. If a person cannot perform two or more ADLs without help, most long-term care policies will approve services such as home health aide support, personal care, or live-in care. At 7 Day Home Care, our licensed caregivers assist with all six ADLs and create customized care plans based on the client’s functional needs and policy coverage.
ADLs vs. IADLs: What’s the Difference?
While ADLs focus on basic physical functioning, Instrumental Activities of Daily Living (IADLs) refer to more complex tasks that allow someone to live independently, such as:
- Managing medications
- Preparing meals
- Shopping for groceries
- Organizing and accompanying on appointments
- Using the telephone or technology
- Doing housework or laundry
IADLs are not typically used by insurers to determine eligibility for long-term care benefits, but they are still crucial to overall well-being and independence. Many of 7 Day Home Care’s services also address IADLs as part of our comprehensive care plans.
How 7 Day Home Care Supports ADL Needs
Our certified home health aides are trained to support clients with both ADLs and IADLs in a way that promotes safety, dignity, and independence. Whether your loved one needs help bathing, getting dressed, or transferring safely from bed to wheelchair, our team provides skilled and compassionate care backed by nursing oversight and real-time communication with families. We also document ADL assistance daily to meet long-term care insurance requirements and ensure uninterrupted benefits.
Key Benefits of Using AOB for Home Care
Faster Access to Care
By avoiding reimbursement delays, care can start right away.
Reduced Out-of-Pocket Costs
Families avoid having to pay large sums up front and wait weeks for reimbursement.
Less Paperwork
7 Day Home Care handles document submissions including nursing assessment, care plan, invoicing, and daily care notes
Transparency & Accuracy
We communicate directly with you and the insurers to avoid billing errors or missed payments.
Improved Continuity of Care
Since there’s no financial gap, care can continue uninterrupted.
Is Assignment of Benefits Safe?
Yes, when working with a licensed, insured, and experienced agency like 7 Day Home Care, the AOB process is completely safe. We:
- Provide clear documentation and authorization
- Keep clients informed at every step
- Only bill for services provided and covered under your policy
We follow all New York State Department of Health regulations and maintain full transparency in billing.
When AOB Is Not Allowed: What to Do
Some older policies or insurance companies may not permit AOB. In those cases:
- We assist clients in submitting claims for reimbursement
- We provide detailed billing documentation for every service
- We help families understand policy language and advocate for fair treatment
Our goal is to make sure you receive every hour of care your policy allows.
Frequently Asked Questions
Can I assign my LTC benefits to 7 Day Home Care?
Yes, if your policy allows it. We will review your policy and walk you through the steps to sign the AOB form.
What if my insurance doesn’t allow AOB?
You can still receive care. We will bill you directly and help you submit claims to your insurer for reimbursement.
Does AOB affect how much care I can receive?
No. It simply changes how the services are billed and paid. Your benefits are based on your policy.
Can AOB be revoked?
Yes. You or your authorized representative can cancel the AOB at any time in writing.
Why Choose 7 Day Home Care?
7 Day Home Care is one of New York’s top home care agencies, with deep experience working with long-term care insurance and Assignment of Benefits. We serve families across:
- Manhattan
- Queens
- Brooklyn
- Nassau and Suffolk Counties
We are licensed by the NYS Department of Health and have an exceptional track record of care.
What We Offer:
- 24/7 availability
- Same-day care start
- Bilingual staff
- Personalized care plans
- Specialized Alzheimer's and dementia in-home care
- Specialized post surgery, stroke recovery, cancer support in-home care
- Help with LTC insurance claims, appeals, and AOB setup
How to Get Started
Getting started is simple:
- Call us at (516) 408-0034 to schedule a free consultation.
- Send us your policy for a free benefit verification.
- Sign the AOB form if your policy allows.
- Start care immediately with one of our trained home health aides.
We work with your physician, insurance company, and family to create a care plan that meets your needs without delay.
Final Thoughts: AOB Gives Families Peace of Mind
Navigating long-term care insurance can be stressful, but an Assignment of Benefits helps reduce that stress by eliminating delays, simplifying finances, and allowing care to begin when it’s needed most. At 7 Day Home Care, we make the AOB process seamless and secure. Whether you're caring for a loved one with dementia, recovering from surgery, or managing chronic illness at home, our team is ready to support you with professionalism, compassion, and efficiency. 7 Day Home Care provides private pay in-home care services and is a approved provider under your long term care insurance policy throughout NYC, Manhattan, Queens, Brooklyn, and Long Island, New York. To learn more about our specialized dementia in-home care services, please call 516-408-0034.
Brian Callahan
7 Day Home Care
