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

Are You Still Chasing the Almighty Dollar, Even Though You Have Plenty to Retire?
retirement

Are You Still Chasing the Almighty Dollar, Even Though You Have Plenty to Retire?

In our experience, many have saved enough money to retire comfortably. Yet too many worry about their money running out and want more. Maybe it’s tim…
May 6, 2021
Child Tax Credit 2021: Who Gets $3,600? Will I Get Monthly Payments? And Other FAQs
Coronavirus and Your Money

Child Tax Credit 2021: Who Gets $3,600? Will I Get Monthly Payments? And Other FAQs

People have lots of questions about the new $3,000 or $3,600 child tax credit and the advance payments that the IRS will send to most families in 2021…
May 4, 2021
9 Tax Deadlines for May 17 (It's Not Just the Due Date for Your Tax Return)
tax deadline

9 Tax Deadlines for May 17 (It's Not Just the Due Date for Your Tax Return)

Between due dates for extension requests, IRA or HSA contributions, and other deadlines, there's more to do by May 17 than just filing your federal in…
May 4, 2021

Recommended

Umbrella Insurance – Do I Need It?
insurance

Umbrella Insurance – Do I Need It?

You might think your home and auto insurance offer more than enough coverage, but if you’re wrong, one very bad day could wipe out your wealth. That’s…
May 5, 2021
Stimulus Plan Has Health Insurance Benefits, Too
Coronavirus and Your Money

Stimulus Plan Has Health Insurance Benefits, Too

The plan’s health care provisions could deliver big savings for early retirees and laid-off workers.
April 29, 2021
Surprise Medical Bills Are Coming to an End
health insurance

Surprise Medical Bills Are Coming to an End

With the No Surprises Act taking effect in 2022, patients will no longer live in fear of receiving an unexpected and exorbitant medical bill for emerg…
April 27, 2021
7 Ways to Utilize Your Life Insurance Policy’s Cash Value
life insurance

7 Ways to Utilize Your Life Insurance Policy’s Cash Value

If you no longer need life insurance, don't just cancel the policy and cash out. Instead, consider one of these strategies to capitalize on its value …
April 23, 2021