What is the LTC insurance elimination period and how does it affect home care?
Key facts
- Common elimination periods
- 30, 60, or 90 days
- Two counting rules
- Calendar days OR paid-care days (policy-specific)
- 90-day @ $200/day out-of-pocket
- ~$18,000 before first reimbursement
- Elimination frequency
- Once per policy lifetime (most policies)
- Common strategy
- Front-load hours during elimination to clear the clock
Every LTC insurance policy sold in the United States has an elimination period — the deductible expressed in days rather than dollars. It is one of the most consequential and least understood parts of the policy. A 90-day elimination on a $200/day benefit means the family pays roughly $18,000 out of pocket before the first dollar of reimbursement arrives.
The two counting rules produce very different outcomes. Calendar-day (or service-day) counting starts the clock the day the trigger is documented and runs continuously. Paid-care-day counting only advances the clock on days the family actually receives paid, agency-invoiced care — meaning weekends without care, or a low-hours-week schedule, does not count.
For Southeast Michigan families, the practical consequence: if the policy uses paid-care-day counting and the family only books three shifts a week, a 90-day elimination can take 30+ weeks to clear. Reading the policy language on this specific point saves months of confusion.
Planning workaround: front-load care hours during the elimination period so the clock clears faster. Once the elimination is satisfied, benefits start and hours can be reduced to normal cadence. Some agencies (including ours) will document a suggested elimination schedule at the free assessment.
For the full breakdown, see the cornerstone: Long-Term Care Insurance and Home Care guide.
Related questions
- Do all 6 ADL trigger days count during the elimination period?
- Yes — the trigger must be met on each counted day. If the case improves temporarily, the clock can pause.
- Can two elimination periods run at once for a couple?
- Rider-dependent. Some shared-care policies allow one satisfied elimination to unlock both spouses; check the policy.
- Do assisted living days count toward elimination?
- Yes for most comprehensive policies. Room and board portion may not count; care level surcharges typically do.
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