Insurance guide

The policy is the easy part. The paperwork is not.

Most long-term care policies do cover in-home care. Most denied claims are not about coverage — they are about documentation nobody was told to keep.

Elimination periodCare planDated recordsCarrier varies

Will long-term care insurance pay for in-home care?

Often yes — these policies are designed for exactly this. What varies is the carrier, the policy year and the conditions attached. Most have an elimination period, a waiting stretch before benefits begin that is frequently counted in days of paid care. Most also require a written care plan and dated visit records. Personal Touch Home Care accepts a number of carriers, though not every carrier and not every policy.

The three things that trip families up

The elimination period. Benefits usually do not start on day one. Many policies count it in days of paid care received, which means you pay out of pocket first and the clock only runs while care is actually happening.

The documentation. Carriers commonly want a written care plan and dated records of every visit. If nobody kept those from the start, a claim months later becomes very difficult to substantiate.

The trigger. Most policies require the person to need help with a set number of activities of daily living, assessed in a particular way. That assessment is the carrier's, not ours.

Do this before care starts

It is far easier than fixing it later:

Find the policy document, not just the card — the conditions are in the document
Call the carrier and ask specifically: elimination period, how it is counted, and what documentation they require
Ask whether they require a licensed agency, and confirm before you commit to a provider
Get the care plan in writing from the start rather than reconstructing it
Keep dated records of every visit from day one, even during the elimination period
Tell us the carrier's name on the first call and we will tell you plainly whether we work with them
Do not assume a policy does not apply because it is old — check

Common questions

Do you bill the insurance company directly?

It depends on the carrier and the policy. Tell us who the carrier is and we will tell you how it works with them rather than guessing.

What is an elimination period?

A waiting stretch before benefits start. Many policies count it in days of paid care received rather than calendar days, which surprises people.

Our policy is from the 1990s. Is it worth checking?

Yes. Older policies are sometimes more generous than newer ones. Read the document rather than assuming.

What if the claim gets denied?

Frequently it is documentation rather than coverage. That is why keeping dated records from day one matters so much, and why we would rather set that up at the start than argue about it later.

Personal Touch Home Care provides non-medical in-home care. Our caregivers assist with daily living, safety and companionship. They do not provide nursing, wound care, injections, physical therapy or any service requiring a licensed clinician. If that is what is needed, it is a home health agency, and we will tell you so.

Talk to someone about your situation.

Call and describe what is happening at home. We will tell you what we can do, what we cannot, and what it would take.

☎ (575) 639-3341 Request care →