Initial Functional Assessment

Genworth Guide to Making a Claim

The initial functional assessment is conducted by an assessing nurse. The nurse will assess your functional abilities, cognitive status, personal needs and environment in order to assist us in determining your benefit eligibility.

You should have the following documents and information readily available during the interview:

• Two forms of photo identification (drivers license, ID card, passport);

• Names and phone numbers of all primary care and treating physicians;

• A list of all current medications, including dosages;

• Names and contact numbers for any current caregiver(s); and

• Medical history, such as hospital confinement dates, procedures and diagnoses.

Please plan to have a family member or caregiver present during this assessment.

Following the interview, the information obtained during the assessment will be provided to a Privileged Care Coordinator (PCC) who will then summarize it and forward the information to Genworth.

For Reimbursement claims only, where required by the policy or certificate, the PCC will also work with the assessing nurse to develop a personalized Plan of Care (POC) for you, and depending upon your care needs and policy or certificate's eligibility requirements, the PCC may also provide a Chronically Ill Certification.

The POC is a written individualized plan for the services you may need, the hours of care needed per week, and what, if any, special equipment you may need.

In developing the POC, the PCC focuses only on your health and well-being, and does not consider the benefits available in your policy or certificate. Therefore, it is important to understand the following:

• Because a service is included in a POC does not mean it is covered by your policy or certificate.

• Because something is included in a POC does not mean you are obligated to make use of the service or item.

The PCC can also help identify resources, such as home health agencies and assisted living facilities, and can make suggestions for your specific care needs.

Please note: If you reside in a nursing home, a PCC may contact the facility directly to obtain the information needed to assess your care needs.