What Does Long-Term Care Insurance Cover?

Long-term care insurance covers the costs of long-term care at home or in care facilities. It’s different than health insurance and Medicare, which don’t typically cover long-term care costs. With many adults needing long-term care at some point in their lives, a long-term care insurance policy can protect finances to cover the cost of care without using up all of the person’s savings.  

When a covered person needs to use long-term care insurance, there’s typically a short elimination period lasting 30 to 90 days. During that time, the person pays for all the care out of pocket. After the elimination period, the insurance company begins reimbursing them for covered care costs based on the specifications of the policy. 

Long-Term Care Insurance Covers Various Settings

Long-term care can take place in a variety of settings, including care received at home and care provided by a facility. Most long-term care insurance policies are comprehensive, meaning they cover the costs of care in all types of settings. This typically includes care received in:

• Personal homes
• Assisted living facilities
• Nursing homes
• Memory care facilities
• Adult day care centers
• Hospice facilities

For recipients receiving care at home, the coverage pays for a variety of service providers who come into the home, including those administering skilled nursing care. It also covers various types of therapy, including occupational, physical, rehabilitation and speech therapy. Personal care assistance also qualifies when the covered person needs help with activities such as dressing or bathing. With many policies, the personal care category includes help with cleaning the house and preparing meals. 

Coverage Amounts Vary

Every policy is different, with coverage amounts varying based on the terms of the policy. The policy has a daily maximum amount it will reimburse the policyholder for. It also has a maximum number of days the policy will pay. Applicants can choose optional features, such as reducing the number of restrictions on what’s covered or increasing coverage to deal with inflation. These options can increase the amount of coverage for long-term care.

What Long-Term Care Insurance Doesn’t Cover

Applicants who have health conditions might be denied a policy, or they might face exclusions for a certain time period after the policy starts. Some policies won’t pay for in-home care if a family member is administering the care. These policies also don’t cover medical expenses. They only cover long-term care. A regular health insurance policy or Medicare should cover medical expenses to work with the long-term care policy.