Does your loved one have a Long-Term Care (LTC) Insurance policy? If so, it’s time to put it to use before it’s too late! Many families wait too long to activate their benefits, risking unused coverage, continued premium payments, and lost financial assistance that could be helping your loved one stay safely at home.
Can Mom Use Her LTC Insurance for Home Care?
Q: Does my mom’s LTC insurance cover home care?
✅ Yes, if she meets eligibility requirements! Most policies cover home care if she needs assistance with two or more Activities of Daily Living (ADLs)—like bathing, dressing, or mobility—or has a cognitive impairment like dementia.
Q: How do we start the claim process?
📋 First, check the policy details—every LTC plan is different! Look for:
- Covered care providers (some policies only cover agency-based care).
- The elimination period (waiting period before benefits kick in).
- Daily or lifetime benefit limits.
Q: What does “ADL assistance” mean for eligibility?
ADL assistance: Policies typically require help with two out of six ADLs: bathing, dressing, transferring, toileting, eating, and continence.
➡ Example: If Mom needs help getting in and out of a chair or bed safely (transferring) then she also needs assistance getting to and from the toilet safely, that meets the two-ADL requirement.
➡ If she struggles with mobility, she likely also has toileting impairment, which should qualify her even if she hasn’t been formally assessed yet.
Q: When I start using my LTC insurance for home care, do I still have to pay premiums?
✅ In most cases, NO! Most LTC policies have a Waiver of Premium clause, meaning that once benefits kick in, you no longer have to pay your policy premiums.
Q: How do I know what my policy pays today?
📞 Call your LTC provider and request a current Explanation of Benefits. Many policies include an escalation clause, which increases your benefits annually.
➡ Example: A policy that paid $100 per day in 1990 with a 5% compound increase would pay significantly more today! Find out what your coverage is worth NOW.
A policy that paid $100 per day in 1990 with a 5% compound increase each year would pay approximately $551.60 per day in 2025. Did your parent add this to their policy?
Q: What’s the biggest mistake families make with LTC insurance?
❌ Waiting too long to use it! Many families hesitate because they think they should “save it for later.” But here’s the truth:
- You may be paying unnecessary premiums.
- Waiver of Premium means using benefits now could stop those payments (premiums are forgiven).
- You don’t have to use the full amount—you can draw down only what you need.
- The sooner you use it, the sooner your loved one gets the care they need to remain in their forever home.
Q: What is the elimination period? How does it work?
📅 The elimination period (EP) is the waiting time before benefits start. It varies by policy:
- Zero-Day Home Care EP: Benefits start immediately for home care.
- 30, 60, or 90-Day EP: Some policies require service days (days with care visits) or calendar days (all days count).
- Genworth & Other Providers: Genworth, one of the largest LTC insurers, has over 1,000 different contract forms—you must check the specific terms for your personal policy.
Steps to Access Long-Term Care (LTC) Benefits
✅ Step 1: Confirm Eligibility: Cognitive Impairment OR Assistance with 2 ADLs
✅ Step 2: Start Home Care Services with a company that specializes in LTC Claims, Home Care Partners 402-780-1211.
✅ Step 3: Call Your LTC Provider to Open Your Claim.
✅ Step 4: Get Your Claim Number & Share it with Your Home Care Agency.
✅ Step 5: Schedule the LTC Assessment (ensure a responsible party is present).
✅ Step 6: Confirm that your Home Care Provider will submit Visit Records every two weeks (fax or provider’s preferred method).
✅ Step 7: Set Up Reimbursement (Auto-deposit or mailed check) to the policy holder.
✅ Step 8: Confirm if Additional Documentation is Required from your medical provider.
✅ Step 9: Add Authorized Responsible Parties to Ensure Easy Communication for your family involved.
📞 Call Home Care Partners today! 402-780-1211
Don’t let your loved one’s LTC benefits go to waste. Let’s bring assisted living home for your family. 🏡 #LTCInsurance #HomeCareCoverage #UseItOrLoseIt
Our Caregiving team provides personal one-on-one attention for your loved one. When you are ready to begin your care journey, we are the experts that will answer your questions and help you implement a plan.
Home Care Partners is locally owned and committed to providing Thoughtful, Quality, and Dedicated Care.
- The Peace of Mind I Didn’t Know I Needed - April 14, 2025
- Presenting Parkinson’s Care at LeadingAge Annual Conference! - April 4, 2025
- Honoring Parkinson’s Awareness with Governor Pillen 🏛️💙 - March 20, 2025
