Find the policy before you need it
Long-term care policies are frequently bought decades before they are used, and the details are forgotten in between. Families often go looking for the document during the same week they are arranging urgent care.
If a parent mentions they have a policy, find it now and read it while nothing is on fire. An hour spent early removes a great deal of pressure later.
The five terms that determine everything
- Benefit amount — the maximum paid per day or per month
- Elimination period — days you pay out of pocket before benefits start
- Benefit period — how long payments last, or the lifetime maximum
- Home care coverage — whether it is covered, and at what percentage
- Provider requirements — whether a licensed agency is required
What triggers benefits
Most policies begin paying when the policyholder needs help with a defined number of activities of daily living — bathing, dressing, eating, toileting, transferring, continence — or when cognitive impairment is documented.
The precise threshold and the assessment process are written into the policy. Do not assume; read it, or ask the insurer to state it in writing.
The elimination period catches people out
The elimination period is the waiting stretch before benefits begin, and families routinely underestimate it. Ninety days is common, and during that time care is paid out of pocket.
Some policies count calendar days; others count only days on which paid care was actually received, which takes considerably longer to satisfy. That difference is worth checking before you plan around a start date.
What we can and cannot do
We can supply the written care plan, visit records and invoices insurers typically require, in the format they ask for.
We cannot interpret your policy, predict whether a claim will be approved, or act as your representative with the insurer. Those conversations need to happen directly between your family and the insurance company.
