There is a policy
You have a policy. Nobody has ever explained how to use it.
A long term care insurance policy usually pays for in home care once the insured person needs help with a set number of daily activities, or has a cognitive diagnosis, and once an elimination period has passed. We read the policy with you, help assemble what the carrier asks for, and keep care running while the claim is processed.
Families bring me policies bought in the nineties that nobody has opened since. The letter is intimidating on purpose, and the honest reason claims stall is almost never fraud. It is a missing date, the wrong assessor, or care that started before anyone documented why it was needed.
Two things worth knowing early. First, the elimination period is usually counted in days of care received, not days since you called, so waiting to start care can delay your benefit rather than protect it. Second, carriers want the same handful of documents nearly every time, and you can gather them this week.
How this goes
1. Send us the policy, or the parts you can find
Even a partial document tells us the daily benefit, the elimination period and whether home care is covered at all. If you cannot find it, we can tell you what to ask the carrier for.
2. We work out what triggers it
Which activities of daily living count, who is allowed to assess, and whether a cognitive diagnosis opens the policy on its own. This is the step families guess at and get wrong.
3. Care starts, documented properly from day one
Care notes written the way carriers expect, from the first visit, so the claim is not fighting a paperwork gap later.
4. We stay on the claim with you
Reimbursement timing, invoices in the format the carrier wants, and the follow up calls. You should not be doing that from a hospital corridor.
Questions we get every week
Usually no. Most policies count the elimination period in days of care actually received, so waiting can push your first paid day further out. We will read your specific policy before advising, because there are exceptions.
Have somebody read the policy with you
A policy review call with Teri. Send the document beforehand and we will go through what it actually pays for, line by line.