Long-Term Care Insurance

When Long-Term-Care Policies Kick In

Most policies pay when you need help with two of six activities of daily living or you are cognitively impaired. And most have a waiting period of 60 or 90 days.

Question:

When does a long-term-care insurance policy start to pay out? What are the benefit triggers, and how long do I have to wait before the benefits kick in?

Answer:

Most long-term-care insurance policies require two kinds of benefit triggers before they’ll pay – either you need help with two out of six activities of living (which generally include bathing, dressing, toileting, eating, transferring and continence) or you have severe cognitive impairment. Your doctor usually needs to fill out a form with the details, and the insurer may ask for additional medical records or may require a cognitive screening to verify impairment, says Mike Ashley, owner of Senior Benefits Consultants, in Prairie Village, Kan.

Most long-term-care policies then have a 60- or 90-day waiting period before benefits kick in, or another time period you chose when you bought the policy (called the “elimination period”). In most cases, the same waiting period applies to any type of care you receive, whether it’s in your home, an assisted-living facility or a nursing home. However, some policies, such as many Genworth policies, have a zero-day waiting period for home care but a 60- or 90-day waiting period for all other types of care.

How the waiting period is calculated can vary and is an important feature to consider when choosing a policy. If your policy has a “calendar day” elimination period, you count each day after the benefit trigger is met. In that case, a policy with a 90-day waiting period could start to pay out within about three months after you meet the trigger criteria. But a policy with a “service day” waiting period counts only the days you receive care. If you need care three days a week, it could take more than seven months to reach the 90-day waiting period.

Most Popular

How a Third Stimulus Check Could Differ From the First and Second Payments
Coronavirus and Your Money

How a Third Stimulus Check Could Differ From the First and Second Payments

There's a big push in Washington for a third round of stimulus payments. But the amount and eligibility rules for your third stimulus check could be d…
January 27, 2021
Where's My Stimulus Check? Use the IRS's "Get My Payment" Portal to Get an Answer
Coronavirus and Your Money

Where's My Stimulus Check? Use the IRS's "Get My Payment" Portal to Get an Answer

The IRS has an online tool that lets you track the status of your second stimulus check.
January 18, 2021
When Could We Get a Third Stimulus Check?
Coronavirus and Your Money

When Could We Get a Third Stimulus Check?

President Biden and others in Congress are pushing for a third-round of stimulus checks, but it might be a while before we get them.
January 20, 2021

Recommended

12 Ways the Biden Stimulus Package Could Put (or Keep) Money in Your Pocket
Coronavirus and Your Money

12 Ways the Biden Stimulus Package Could Put (or Keep) Money in Your Pocket

President Biden's "American Rescue Plan" includes several proposals to assist people financially harmed by the pandemic.
January 20, 2021
What You'll Pay for Medicare in 2021
Healthy Living on a Budget

What You'll Pay for Medicare in 2021

For Medicare premiums 2021, look for modest increases in premiums and out-of-pocket costs.
December 16, 2020
Is Your Cash Value Life Insurance Policy Still a Good Fit for You?
life insurance

Is Your Cash Value Life Insurance Policy Still a Good Fit for You?

Over the years, you could have grown out of it. Or maybe your life insurance policy’s performance didn’t live up to your expectations. In any case, yo…
November 30, 2020
Making Wise Choices During Open Enrollment
health insurance

Making Wise Choices During Open Enrollment

Contributing Editor Lisa Gerstner runs through the new variables of the 2020 open enrollment season. Also, hosts Sandy Block and David Muhlbaum talk a…
November 17, 2020