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Using long-term care insurance for care at home

Most policies pay for help at home, not just nursing homes. Here’s how to start a claim.

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At a glanceHow most policies work
Reviewed Oct 2026
  • Pays whenHelp needed with 2 of 6 daily tasks, or memory loss
  • Waiting periodOften 20 to 100 days
  • Family caregiversMost policies don’t pay them
  • To startCall the claims number on the policy
  • Complaints(866) 445-5364
SourcesHow to start

When a policy pays

Most policies sold today pay for care at home once a licensed professional confirms you need it.

  • You need help with at least 2 of 6 daily tasks: bathing, dressing, eating, toileting, continence, or getting in and out of a bed or chair.
  • The need is expected to last at least 90 days.
  • Or you need supervision because of serious memory loss or confusion.
  • A doctor, nurse or licensed social worker certifies it.
  • Care follows a written plan of care.

Can’t find the policy? Look for papers from the insurance company, or ask whoever helps with finances. We can read it with you.

A caregiver and an older woman talking at the kitchen table

How to start

Most claims follow the same path. Keep notes of every call.

  1. Find the policy

    Look for the company name, the policy number and the claims phone number.

    First

  2. Call the company

    Say you want to start a long-term care claim. They’ll send forms. If you’re calling for a parent, they may ask for a power of attorney.

    Day one

  3. Assessment

    The company reviews medical records and may send a nurse, in person or by video.

    Assessment

  4. The waiting period

    Most policies pay only after a waiting period, often 20 to 100 days. Care during it is usually yours to pay.

    20 to 100 days

  5. Invoices and payment

    Send itemized invoices each month. Some companies pay the agency directly if you sign an assignment of benefits.

    Monthly

Good to know

The questions families ask most.

Can a family member be paid?Usually not.

Most policies don’t pay family members, and their care may not count toward the waiting period. A few allow it with limits, so read the policy.

Other ways family can be paid: Paid family caregiver guide.

How the waiting period countsCalendar days or service days.

Some policies count every day you qualify. Others count only days you receive paid care, so three visits a week takes much longer to count down than daily care. Ask which kind yours is.

How it paysActual costs, or a set amount.

Most policies pay your actual costs up to a daily or monthly limit. Some pay a set amount whatever you spend, and you decide how to use it.

Life insurance with a care riderIt may pay too.

Some life insurance policies let you use part of the death benefit for care while you’re alive. It usually lowers what’s left for your family, and it uses the same test of need.

If a claim is deniedAsk why, in writing.

Ask the company for the reason and how to appeal. For help, call the Illinois Department of Insurance at (866) 445-5364.

TaxesPremiums can count as a medical expense.

Part of what you pay for a long-term care policy can count as a medical expense, up to a limit that rises with age ($6,200 a person at 71 and older in 2026).

Where VitalTouch fits

Most policies require a licensed home care agency. We’re licensed by the State of Illinois, and we do the paperwork with you.

  • We read the policy with youWhat it pays, the waiting period, and what it leaves out.
  • Invoices the company acceptsItemized by task each month, not just hours.
  • We can bill the companyWhen your policy allows an assignment of benefits.
What we can do todayVitalTouch, Oct 2026
Honest answer
  • Licensed home care agency
  • Help with the claim forms
  • Itemized invoices every month
  • Bill the insurer directly, when allowed
  • Policies that require a Medicare-certified agency
(708) 726-4536Free coverage check

Local help with a policy

Chicagoland long-term care insurance agents and financial advisors who help families plan for the cost of care.

We’re inviting local agents and advisors. Listings are free. Nobody pays us to be listed, and we don’t pay for referrals.

Are you a long-term care insurance agent or financial advisor? Get listed here, free. Email ifeanyi@vitaltouch.care or call (708) 726-4536.

Other ways to pay

Sources

General information, not legal or benefits advice. Rules change, and each program decides for itself. Last reviewed October 12, 2026.

Have a policy?

Tell us the company. We’ll check it with you, free.

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