Long-term care insurance is a specialized type of insurance that pays for caregiving services at home or if you transition to a care facility.

People believe that your personal or company health benefits or medicare or medicare supplement plans will pay for caregiving services. These benefits do not pay for caregiving services.

I emphasize to my clients that owning a long-term care plan is valuable; however, owning a plan funds your caregiving, but additional planning is essential.

  1. Have your caregiving plan in a folder and a known place to your family and copies with your trusted advisor. You may also scan or have your LTC plan and other documents in digital folders or digital services offered by companies.
  2. Review your plan every few years. If you forget what your plan will accomplish, contact your extended-care benefits advisor or contact customer service of the LTC company.
  3. Have your other documents in a known place to your family and trusted advisors. Legal documents, Financial Assets, Medical Forms, Doctor and Prescription Information, Passwords, and other essential information will help those responsible for your care to help you with your care services and care requirements. Have the telephone, address, and e-mail of your LTC carrier.
  4. Inform your family and trusted advisors you own a long-term care plan and have a summary of your plan available for family, fiduciary, and advisors.

What do you need to have to file a long-term care claim?

Articles have been written, and influencers in social media do not think LTC benefits are useful because they don’t understand the fundamentals of LTC plans, and people forget the plans they purchased.

Long Term care benefits claims mean “activities of daily living.”

You have a medical condition with health insurance, and you use your doctor and hospital benefits.

With an LTC plan, it isn’t the illness where you may file a claim; it is how the illness, accident, or frailty affects your activities of daily living.

Bathing, Continence, Dressing, Eating, Toileting, and Transferring are activities of daily living.

There are one more activities which are cognitive. If you have been diagnosed with a cognitive illness, you do not need to have another activity of daily living condition.

This is what is in all Long Term Care Plans:

The Benefit Amount

Think of it as the bank account (how much money is in your account) of either a Traditional or Hybrid Benefit.

The amount in the account can be $100,000; $200,000, $400,000, to over $1,000,000 based on how the LTC plan is designed.

Then it is the monthly amount which may be between $1,000 to $15,000 in the beginning, and if there is a cost of living rider.

How many years based on family history would you need care services? 2 years, 3,4,5,6, or lifetime benefits?

Waiting period. To save money on premiums, people will extend the waiting period before benefits begin. The typical waiting period is 90 days. It is important to know if the waiting period is calendar or service days in your policy. Calendar days are better as your waiting period is counted faster than service days.

What Kind of Care Is Covered by the Policy?

Most long-term care benefits after the year 2000 are comprehensive, meaning you may use the plan at home, living with friends or family, or if you need to transition to a care center.

Care Support Services.

During the years you own the plan care support services won’t be thought of as useful, but when filing a claim and the issues around what, how, and where care support services are needed, a family has options:

  1. There are care support services at no additional expense offered by the LTC insurance carriers. A family may contact the carrier which contracts with a care support service to help a family evaluate a person’s care needs.

A family may hire a licensed and experienced gerontologist, social worker, or competent caregiving services to evaluate a person’s caregiving needs. The family pays for these services.

There are also care support agencies such as Amada, who will help a family file a claim and make sure that the purpose of the claim and documentation of the plan’s benefits are correctly organized so that the insurance carrier will certify the lawsuit without delay.

Amada Care Services


Amada Senior Care

How much time does it take for an LTCI claim determination to arrive?

Bathing, Continence, Dressing, Eating, Toileting, and Transferring are activities of daily living.

LTC claims are delayed or denied because caregiving is not that you are frail, have an accident, or are ill. It is whether recovery will be longer than 90 days and how your health, fragility, or cognitive affect your activities of daily living.


  1. Have your LTC benefits policy in a document and digital form available for your family and your trusted fiduciary and advisors.
  2. Have a Summary of your LTC Benefits Policy
  3. Waiting Period
  4. Monthly benefits
  5.  Cash, Reimbursement, or combination cash/reimbursement
  6. Cost of living added to your monthly benefits
  7. Years plan will pay
  8. Carrier phone number, e-mail, and mailing address

Consultation with primary care physician, and the insurance carrier information needed to be eligible to receive your benefits.

  1. Consult with Amada, a care support consultant, or your extended-care benefits advisor with how to properly apply for benefits so that certification will be made promptly to receive your benefits.
  2. Have your important financial and insurance documents in folders in a place your family and trusted advisors can find. Digital services are useful where your documents are scanned and in a cloud, system to make it easier for families to find essential information.

Digital Links to host your documents.

  1. Care Support Information: http://www.cool.net/
  2. https://www.digitallifecloud.com/Home.jsp
  3. https://www.jotform.com/blog/personal-document-management-software/
  4. https://evernote.com
  5. https://clocr.com
  6. https://www.pinventory.com