Form F-01567 Long-Term Care Insurance Policy - Assignment of Benefits - Wisconsin

What Is Form F-01567?

This is a legal form that was released by the Wisconsin Department of Health Services - a government authority operating within Wisconsin. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form F-01567?
A: Form F-01567 is a document used for the assignment of benefits of a long-term care insurance policy in Wisconsin.

Q: What is a long-term care insurance policy?
A: A long-term care insurance policy is a type of insurance that helps cover the costs of long-term care services, such as nursing home care, home health care, and assisted living.

Q: What is the assignment of benefits?
A: The assignment of benefits is the transfer of the right to receive payment for long-term care services from the policyholder to another entity, such as a healthcare provider or a care facility.

Q: Why would someone assign their long-term care insurance benefits?
A: Someone may assign their long-term care insurance benefits if they want the payment for their care services to go directly to the healthcare provider or care facility, rather than receiving reimbursement.

Q: Is the assignment of benefits mandatory in Wisconsin?
A: No, the assignment of benefits is not mandatory in Wisconsin. It is a voluntary decision made by the policyholder.

Q: What information is required in Form F-01567?
A: Form F-01567 requires information such as the policyholder's name, policy number, the name and address of the assignee, and a signature.

Q: Are there any fees or costs associated with the assignment of benefits?
A: The assignment of benefits itself does not usually involve any fees or costs. However, there may be fees or costs associated with the services provided by the healthcare provider or care facility.

Q: Can the assignment of benefits be revoked or changed?
A: Yes, the assignment of benefits can usually be revoked or changed by the policyholder. However, this may require written notification to the insurance company and the assignee.

Q: Is Form F-01567 specific to Wisconsin?
A: Yes, Form F-01567 is specific to Wisconsin. Other states may have different forms or requirements for the assignment of benefits for long-term care insurance policies.