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

Tax-qualified LTC insurance policies use the same trigger the IRS uses: the insured must be unable to perform at least 2 of the 6 activities of daily living — bathing, dressing, toileting, transferring, continence, eating — for an expected 90 days or more, OR require substantial supervision due to severe cognitive impairment such as moderate dementia.

After the trigger is documented (assessment by a licensed care manager or RN), the elimination period begins — usually 30, 60, or 90 days that the insured pays out of pocket before benefits start. Some policies count calendar days; others count only days that care was actually received.

Once benefits start, the policy pays up to a daily or monthly cap. Older policies often reimburse a per-hour amount; newer policies pay a daily indemnity regardless of actual hours. Most policies require a licensed home care agency (not a private-hire caregiver) to release benefits.

In Southeast Michigan, typical agency rates for Personal Care ($29 to $37 per hour) and 24-hour live-in care ($400 to $500 per day) usually fit within modern policy caps. Bring the declaration page and the benefit-triggers section of the policy to your first agency call so care coordination and claim filing start on day one.

For the full breakdown, see the cornerstone: LTC Insurance & Home Care guide.