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Using Long-Term Care Insurance for In-Home Care

6 minute readLast updated April 6, 2023
Written by Rebecca Schier-Akamelu, assisted living writer
Reviewed by Todd Austin, home care expertTodd Austin, an Aging Media "40 under 40" winner and home care expert, heads Home Care Pulse, a leading home care agency software solution.
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If your parent or loved one has a long-term care insurance policy or is considering buying one, you may wonder about the coverage they’ll have. Especially because many seniors want to age in place, it’s important to figure out whether in-home care is covered under a long-term care insurance policy. Check their policy to find out whether home care is covered and, if so, which services. Given the difference between health care needs and more basic support around the house, you’ll want to know exactly what is and isn’t covered.

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Does long-term care insurance cover in-home care?

Many long-term care insurance policies cover services for in-home care and home health care.[01] You’ll need to be aware of the specifics of your loved one’s policy, however, since sometimes the policy language refers to other types of care.

For example, some policies allow the insured to choose a benefit amount for nursing home care, with in-home care covered at a percentage of the nursing home benefit. Other policies may have the same benefit amount regardless of whether you receive care at home or in a nursing home.[02]

You’ll also want to be aware of which in-home care services your policy covers, as there’s a difference between home health care and home care. Many comprehensive policies cover the following services at home:

  • Skilled nursing home care
  • Help with activities of daily living, such as bathing or toileting
  • Occupational therapy
  • Physical therapy
  • Rehabilitation [03]

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Home health care

Home health care is medical care received at home. It refers to skilled nursing care as well as in-home visits from occupational, physical, and/or speech therapists. Home health care is prescribed by a health professional such as a doctor or nurse practitioner, and your loved one would need to work with a home health care agency to make sure they’re receiving the care prescribed in their plan.

Home health care is more expensive than home care, which makes sense considering your loved one will receive care from a home health aide, registered nurse, or licensed therapist. However, since this is health care, it is often covered by Medicare, Medicaid, or private health insurance. This will help reduce the amount you pay out of pocket before turning to a long-term care insurance plan.

You might notice the higher cost of home health care reflected in your loved one’s long-term care insurance policy. Some long-term care insurance policies offer a specific home health care benefit, and these policies tend to be more expensive.[02]

Home care

Home care is nonmedical assistance from a caregiver. Your loved one can receive assistance with activities of daily living (ADLs) including the following:

  • Bathing
  • Dressing
  • Eating
  • Toileting
  • Transferring

Home care is a wonderful option for seniors as it’s typically easy to customize for their needs. For instance, maybe your loved one needs assistance on a part-time basis but is fine on their own for large parts of the day. You can choose from a range of home care agencies, or you can hire an independent caregiver to assist your loved one.

Hiring an in-home caregiver is an important consideration if you’re hoping to cover the cost with a long-term care insurance policy. Some long-term care insurance policies have requirements for hiring a caregiver, such as requiring the caregiver to work for a licensed provider or agency.[02]

Also, most policies won’t pay benefits to a family caregiver. Depending on the policy, using a family caregiver may affect your loved one’s elimination or waiting period, which affects when they can receive benefits.[02]

Using long-term care insurance to pay for in-home care

Your loved one may already have a policy in place, or they may be considering buying one. When you’re purchasing a policy, many factors can affect the cost — and the benefits you’ll receive.

Consider the following factors and weigh them against your loved one’s care needs:

  • The maximum amount the policy will pay per day
  • The maximum number of years a policy will pay benefits
  • The lifetime maximum amount that the policy will pay
  • Optional benefits that may affect the policy, such as benefits that increase with inflation [03]

It’s important to consider how long your loved one may need care and how expensive care is in their area. While you may be able to use a loved one’s long-term care insurance to pay for in-home care, it may not cover the entire cost if the daily benefit that’s paid is less than what you’re paying the caregiver. In this case, you may want to prepare alternative ways to cover the cost of in-home care.

Long-term care insurance policies often have a waiting or elimination period before benefits will be paid. During this time, you’ll need to pay for home care using other means. It depends on your policy, but the elimination period could range from 20 to 100 days before the policy will begin paying benefits.[02]

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Buying a long-term care insurance policy

Long-term care insurance policies are typically purchased through an insurance agent. Your loved one might have purchased an individual policy or been offered a group policy through an employer or an association.[01]

Work with a trusted financial expert if your loved one is considering buying a long-term care insurance policy. Your loved one’s health and age can affect the cost of the insurance premiums. Unfortunately, should your loved one be unable to pay the premiums, they’ll probably lose their coverage. If their policy includes a nonforfeiture benefit, they may be able to get some of the policy’s value back from the amount they’ve paid so far.[02]

Other payment options

Depending on your loved one’s long-term care insurance policy, you may find that a portion of the home care or home health care they need isn’t eligible for benefits. In that case, you may want to consider using Medicare or Medicaid to pay for long-term care at home.

Medicare covers the following services:

  • Part-time skilled nursing home care
  • Physical therapy
  • Occupational therapy
  • Speech-language pathology services [04]

Medicaid coverage will vary depending on your state, but it generally covers several aspects of home care and home health care. Each state also has Home and Community Based Services (HCBS) waivers, which can help you get additional home care coverage. The Medicaid state-by-state eligibility map can help you see what’s offered in your state.

Choosing care

Whether you’re using a long-term care insurance policy or another payment option to pay for home care, you’ll want to make sure you’re hiring a caregiver who will be a good fit for your loved one. The Senior Living Advisors at A Place for Mom are familiar with many home care agencies and can help you find the right caregiver, all at no cost to you.

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  1. National Association of Insurance Commissioners. (2022, February 11). Long-term care insurance.

  2. National Association of Insurance Commissioners. (2019). A shopper’s guide to long-term care insurance.

  3. Administration for Community Living. (2020, February 18).What is long-term care insurance? Longtermcare.gov.

  4. U.S. Centers for Medicare and Medicaid Services. Home health services. Medicare.gov.

Meet the Author
Rebecca Schier-Akamelu, assisted living writer

Rebecca Schier-Akamelu is a senior copywriter at A Place for Mom, specializing in topics such as assisted living and payment options. With more than a decade of experience as a content creator, Rebecca brings a person-centered approach to her work and holds a certificate in digital media and marketing from Duke University.

Edited by

Danny Szlauderbach

Reviewed by

Todd Austin, home care expert

The information contained on this page is for informational purposes only and is not intended to constitute medical, legal or financial advice or create a professional relationship between A Place for Mom and the reader. Always seek the advice of your health care provider, attorney or financial advisor with respect to any particular matter, and do not act or refrain from acting on the basis of anything you have read on this site. Links to third-party websites are only for the convenience of the reader; A Place for Mom does not endorse the contents of the third-party sites.

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