Millions of Americans carry long-term care insurance policies — and many of them, or their families, are not fully aware of what those policies actually cover. A long-term care policy could represent a significant home care funding resource that families leave on the table.

What Long-Term Care Insurance Was Designed For

LTC policies were specifically created to cover services that health insurance and Medicare do not — including non-medical home care, assisted living, and nursing home care. If your loved one has a policy, it was purchased specifically for situations like this one.

Understanding the Benefit Trigger

Most LTC policies activate when the insured cannot independently perform a certain number of Activities of Daily Living (ADLs) — typically two or three out of six: bathing, dressing, eating, transferring, toileting, and continence. Cognitive impairment is also commonly a qualifying trigger.

The Elimination Period

Most policies have an elimination period — a waiting period of 30, 60, or 90 days — before benefits begin. Understanding your policy’s elimination period is important for planning. Many families use private pay during the elimination period and transition to insurance-funded care once benefits activate.

How to Activate Benefits

Contact the insurance company’s claims department and ask specifically about home care benefits. They will initiate a claims process that typically involves a functional assessment. Having documentation from a physician and a care agency describing the type and frequency of care needed will help move the process forward.

How Beyond Care Works With LTC Insurance

We work regularly with families using long-term care insurance to fund home care. We can provide the documentation your insurer needs, assist with the claims process, and help ensure the care plan aligns with your coverage terms.

Ready to talk? Request a free consultation or call us at (864) 841-2500. The first conversation is always free.