Long-term care

When can I appeal?

If an insurance company says you do not qualify for long-term care benefits, you may be able to appeal. Disputes most likely involve decisions about whether you can no longer perform certain activities of daily living or have a cognitive impairment.

To avoid claim denials, it is important that the facility or caregiver keep accurate, detailed care notes about the level of help a policyholder needs to perform activities of daily living. The insurance company will use this information in the claim review process.

How do I appe​al?

Your first appeal is through the company that denied coverage.

If the denial is upheld by the company, your insurer must send you a letter telling you how to file an external appeal. The letter will include this list of Independent Review Organizations.

You may select the company you want to review your case. If you don't name a company, the insurance company will do so on your behalf.

Independent Review Organizations

LTCI Independent Eligibility Review Specialists, LLC
Allentown, Penn.
Stephen R. La Pierre
800-878-9579
slapierre@iberview.com
www.ibereview.com

MCN (Medical Consultants Network)
Seattle, Wash.
Erik Halse
206-343-6100
ehalse@mcn.com
www.mcn.com

Permedion, Inc
Westerville, Ohio
800-473-0802
hmspermedion.com​

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Questions?

Contact: exreview.ins@oregon.gov

Che​ck a license​

Whether you are considering an exciting new investment, getting ready to buy insurance, or applying for a payday or title loan, always be sure to check to make sure the individual or company you are working with is licensed.

Check a license now.​

Licensed payday and title lenders​

Complaint or questions? 

Insuran​ce​​

888-877-4894 (toll-free)
Email cp.ins@oregon.gov 

Financial services​

866-814-9710 (toll-free)
Email DCBS.DFCSMAIL@oregon.gov​

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Key links

Rate information
Medicaid
Ombudsman​​

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