Quick answer
Many long-term care insurance policies cover assisted living, memory care, home care and nursing homes, but each policy is different. Benefits usually start when a doctor or nurse certifies your parent needs help with daily activities or has a severe cognitive impairment, and after a waiting (elimination) period. Find the policy, read the benefits section, and call the insurer to start a claim. (800) 614-8388 and we'll help you find care that fits the policy.
How policies usually pay
- Daily or monthly benefit: the most the policy pays per day or month.
- Benefit period or pool: how long or how much in total it pays.
- Elimination period: days of care you pay for before benefits start.
- Covered settings: which care settings the policy covers.
- Inflation protection: whether the benefit has grown since purchase.
Benefit triggers
For tax-qualified policies, IRS rules describe a chronically ill person as someone certified within the past 12 months as either:
- unable to do at least two activities of daily living (eating, toileting, transferring, bathing, dressing, continence) without substantial help for at least 90 days, or
- needing substantial supervision because of severe cognitive impairment.
Your parent's policy states its own triggers; read them.
How to file a claim
- Find the policy and any updates. Check bank records for premium payments if you can't find it.
- Call the insurer and ask for a claim packet.
- Get the care assessment and a plan of care from a licensed health care practitioner.
- Ask the community or agency whether they have worked with this insurer.
- Keep copies of everything and track the elimination period.
- Ask whether the policy pays the provider or reimburses you.
Medicare isn't long-term care insurance
Medicare doesn't pay for long-term custodial care, which is why long-term care insurance exists. See how to pay for assisted living.
Have a policy and need a plan?
We'll help you find assisted living, memory care or home care that fits the coverage. Free.
Questions families ask
Does long-term care insurance cover assisted living?
Many policies do. Check the covered settings in your parent's policy.
Does it cover memory care?
Many policies cover memory care in assisted living. Check the policy wording.
What is the elimination period?
The number of days of care you pay for before the policy starts paying.
Are long-term care insurance premiums tax deductible?
Part of the premium for a qualified policy can count as a medical expense, up to an age-based limit. See tax deductions.