A qualifying long-term care (LTC) insurance policy can pay or reimburse for in-home personal care — often the difference between affording steady help and going without. Hailo helps families put their policy to work and matches them with agencies that meet their policy's provider rules.
Benefit trigger: most policies pay once a licensed practitioner certifies you need help with two or more activities of daily living (bathing, dressing, transferring, toileting, eating, continence) or have a cognitive impairment such as dementia.
Elimination period: after the trigger, most policies impose a waiting period — commonly 30, 60, or 90 days — before benefits pay. Some count calendar days, others only days you actually receive paid care; the difference matters and is written in the policy.
Policies set a daily or monthly maximum benefit and a lifetime pool. Many require care from a licensed home care agency rather than an independent caregiver; some pay the provider directly while others reimburse the family. Older policies vary widely, so the claim always starts with reading the actual policy language.
Most long-term care policies cover in-home personal care once the benefit trigger is met — usually needing help with two or more activities of daily living or having a cognitive impairment — and after the elimination (waiting) period. Policies differ on daily maximums and approved provider types.
Original Medicare generally does not pay for ongoing non-medical home care such as companionship or help with bathing and meals. It can cover limited, short-term skilled home health after a qualifying event. Long-term care insurance, VA benefits, Medicaid programs like California IHSS, or private pay usually fund ongoing care.
Not sure what your policy covers? Request care or call (213) 451-6802 — Hailo matches you with an agency experienced with LTC insurance claims. See also: private care · California IHSS.