Full Definition

Long-term care insurance (LTCI) is a private insurance product designed to cover care costs that health insurance and Medicare do not — specifically, extended help with activities of daily living (ADLs) or supervision due to cognitive impairment.

Benefits are typically triggered when a licensed health professional certifies that the insured person cannot perform at least two of six ADLs (bathing, dressing, eating, toileting, transferring, continence), or has a cognitive impairment such as dementia requiring substantial supervision.

Policy benefits vary widely. Key terms to understand include the daily or monthly benefit amount, the elimination period (like a deductible measured in days), the benefit period (how long benefits will pay), the inflation protection option, and whether the policy covers home care as well as facility care.

For families whose parent has an LTCI policy, the first step is locating the policy documents and contacting the insurance company to begin the claims process — ideally before or during the transition to care, not after months of private-pay expenses. Many families do not realize benefits are available because they do not know the policy exists or understand how to trigger it.