How do you submit an FLTCIP informal caregiver invoice?

Use the Informal Caregiver Invoice (form A004) and submit it through your My LTCFEDS account under Claims, then Request Reimbursement. You can also email claimsinfo@ltcfeds.gov, fax 1-866-513-2674 with the Claims Fax Cover sheet, or mail it. Record times to the nearest quarter hour, attach proof of payment for each date, and sign by hand. FLTCIP does not reimburse cash.

Send it to FLTCIP

OnlineMy LTCFEDS account, Claims, Request Reimbursement

Emailclaimsinfo@ltcfeds.gov

Fax1-866-513-2674 (use the Claims Fax Cover sheet)

MailFLTCIP, Attn: FedPoint, LLC, P.O. Box 797, Greenland, NH 03840-0797

Phone1-800-LTC-FEDS (1-800-582-3337), TTY 711

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What the informal caregiver invoice must show

Claim ID, the insured's name, and the caregiver's name and relationship.
For each date: time in and time out to the nearest quarter hour, total hours, the approved hourly rate, and the daily total.
The ADLs or services provided, checked for each date.
A check or transaction number for each date, with proof of payment attached. Totals must match.
Handwritten signatures and dates from the caregiver and the insured or legal representative, after the care happens. If one person is both caregiver and representative, a third person also signs.

The gaps we check for before it goes out

Times like 8:10 that aren't on a quarter hour, cash payments, dates with no transaction number, totals that don't match hours times the rate, and a caregiver who is also the legal representative with no third signature.

Questions

How long does FLTCIP take to reimburse?

LTCFEDS says reimbursement is typically within 10 days of receiving all required documents.

Does FLTCIP reimburse cash paid to a caregiver?

No. Cash payments to informal caregivers are not reimbursable.

Who administers FLTCIP claims?

FedPoint, LLC. The insurer is John Hancock Life & Health.

Can I send the invoice two ways to be safe?

Use one submission method only. LTCFEDS asks for one.

Source: FLTCIP's own claims pages (ltcfeds.gov/claims-information), checked October 23, 2026. Your claim approval letter overrides anything general here. If something doesn't match what you were told, call 1-800-582-3337.