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Paying for home care

Using long term care insurance to pay for home care

Many parents bought a long term care policy years ago. Most policies cover care at home, but only once the paperwork is done the insurer's way.

You don't pay. There's no fee.

Book a free callCall (201) 686-8232Prepare a written request instead

Most policies cover home care

Policies from insurers such as John Hancock, Genworth, MassMutual and CNA often pay for care at home from a licensed agency, not only for a nursing home. Older policies can be narrower, so the wording matters.

Find the policy and the latest premium notice. The policy number and the insurer's claims phone number are what you need first.

Five things to find in the policy

  • Benefit trigger: usually help needed with 2 of 6 daily activities (bathing, dressing, eating, toileting, moving, continence) or a cognitive impairment such as dementia.
  • Elimination period: the days of care the family pays first, often 30, 60 or 90. Ask whether it counts calendar days or days of paid care.
  • Daily or monthly home care benefit, and whether it has an inflation rider.
  • Whether the insurer requires a licensed agency, or also pays independent caregivers or family.
  • Whether the insurer pays the agency directly or reimburses your family from invoices.

How a home care claim usually starts

  • Call the claims line and ask for the claim packet for home care.
  • Get the doctor's statement and a written plan of care. The insurer may send its own nurse to assess.
  • Choose a licensed agency that will send invoices and care notes in the insurer's format.
  • Keep every invoice from day one, because those days count toward the elimination period.
  • Ask the insurer to confirm in writing that the agency qualifies.

Choose an agency that works with policies

Some licensed agencies are used to long term care insurance and send the paperwork every month. That saves the family hours of chasing forms. We ask about this up front and introduce agencies that already bill policies.

You don't pay. There's no fee. Call (201) 686-8232 or book a free call with the policy in hand.

What we do not do

We do not sell insurance, we are not your insurer and we do not decide claims. Nothing here is insurance or legal advice. For a denied claim, an elder law attorney is the right next call.

Tell us about the policy

Please do not type Social Security numbers, Medicare numbers, bank details, or medication lists.

What does your parent need help with? Check all that apply.
We never pass your details to a community or partner without asking you first and naming who receives them. We only contact you the way you choose. You don't pay. There's no fee.

How we handle your information

Related pages

Frequently asked questions

Will the policy pay for live-in care?
Many do, up to the daily benefit. If the agency's daily rate is above the benefit, the family pays the difference.
Can the policy pay a family member?
Some policies allow it and many do not. The policy language decides, so ask the insurer in writing.
Does the waiting period start before the claim is approved?
Often yes, if care was from a qualifying provider and you kept invoices. Ask the insurer how it counts the elimination period.
Do families pay you?
You don't pay. There's no fee. A licensed agency may pay us a referral fee after a successful private-pay start of care. We do not take a fee on Medicaid funded care.

Ways to start

Sit with us first. Then pick the home.

Informational and referral only. Not medical, legal, or insurance advice. We do not operate communities or employ aides, and we do not publish community prices, waitlists, or bed counts. Verify licensing and current rates with each community or agency.

This site is not medical or financial advice. Confirm coverage with the plan or the state Medicaid office. Facility fees are set by the community.

Call (201) 686-8232