When and How to Initiate Your Long-Term Care Insurance Policy

By Jeffrey Grossman, CEO Commonwise Home Care.

As a long-term in-home care provider, Commonwise is often adjacent to families as they begin to wrestle with the need for an older adult’s care. For those who have invested in Long Term Care Insurance, understanding when and how to start using the benefit can be very confusing. 

Below are common questions and tips to help clarify the process:

You may have a policy you do not know about.

Adult children often don't realize their parents have LTCI. It's essential to inquire about its existence. Remember, employees of large corporations or the federal government might have received LTCI as a benefit.

Initiate your policy ASAP.

Deciding when to put your policy into action can be a paralyzing question. Families wonder if their loved one will qualify, or whether they should delay initiation until their care needs are greater to preserve the benefit for the future. However, far more families fail to fully utilize their benefit than outspend it. Initiate the policy as soon as you qualify. And remember, "cognitive impairment" and "care management" may also be qualifiers, so read the policy carefully.

The Elimination Period.

LTCI policies usually include an "elimination period," a time when care costs are out-of-pocket. Initiate the policy early, when care needs are minimal, to limit these costs.

Tips for getting started:

Contact the insurance company to initiate your claim and set up a nurse assessment to determine qualification. Having a clinically minded third party attend the LTCI nurse assessment can be productive for families with older adults who “show off” against their own interest.

Understand the reimbursement process:

• Selecting a Provider: Choose a care provider based on the policy's terms. Remember, home care providers often need to be state-licensed.

• Paying for Services: Keep detailed records of services received and payments made. Some quality home care providers can create these records for you.

• Submitting a Claim: Submit a claim form along with relevant documentation. Some home care providers can directly submit these to insurers.

• Receiving Reimbursement: If approved, the insurance company reimburses up to the policy limit.