NAIC · Covered settings
Does Long Term Care Insurance Cover Home Care?
Many long term care policies cover care at home as well as nursing home care. Bring the policy to the table. Tom or Chris will read the benefit page with you line by line, and tell you exactly what it does and doesn’t reach.
Often, yes: according to the NAIC, individual long term care insurance policies often cover home health care, adult day care and assisted living care as well as nursing home care, and families can use a policy for care with Endurance Home Care.
We don't take Medicare, Medicaid or VA benefits as payment. Families pay privately, or claim the cost back from a long-term care insurance policy. If there’s a policy, we help with the policy paperwork.
A long term care policy is written around settings, and care at home is one these policies often cover, alongside adult day care, assisted living and the nursing home most families assume is the whole product. So the useful question is what your own policy covers, in writing.
- Home health care
- Adult day care
- Assisted living care
- Nursing home care
Settings individual long term care insurance policies often cover, per the NAIC consumer guide.
What to check
What to look for in your policy
Start with the policy itself. What it covers is set by its own terms, not by a general rule, which is why fifteen minutes with the benefit page is worth more than an afternoon of searching. The clause families most often miss is the pre-existing condition waiting period. Under many policies, benefits for care related to a condition someone already had may not be paid for a period after the policy takes effect, usually six months. Knowing that early changes when care starts, not whether it starts.
The settings the document names
Home health care, adult day care, assisted living care, and nursing home care are the settings the NAIC says individual long term care policies often cover.
Home care, by name
Look for care at home in the list of covered settings. It's named as its own setting, separate from nursing home care.
The pre-existing condition clause
Care related to a condition someone already had may not be covered at the start, which is the clause families most often miss.
When benefits begin
Under many policies, that exclusion runs for a period after the policy takes effect, usually six months.
What health insurance usually doesn't cover
Endurance's client FAQ states most health insurance plans don't cover daily-living companion or personal care, though a long term care policy may.
What Medicare doesn't cover
Because most long term care is daily-living, Medicare and most health insurance, including Medigap, don't pay for it.
“When I met with Tom and Chris, we discussed our LTC policy and my stress level was very much reduced.”
Published family review, AgingCare
If there’s a policy, have it handy when you call, and we’ll talk through how it fits with the care plan. The founders sit down with the document. The reading is plain: what the policy names, what a waiting period does to your start date, and which hours are going to be private pay regardless. The insurance company decides what it pays, and the terms of the policy set the rules. What we can do is the part families dread doing alone, which is opening the benefit page with somebody sitting on the other side of the table.
Connecticut License HCA.0002450 · New Jersey License HP0435100 · Connecticut DPH License 9915786 (Endurance Home Health).
If there’s no policy
It helps to know early that Medicare and most health insurance, Medigap included, don’t pay for daily-living long term care. The other ways families pay are each explained on their own page.
- If you have a policy
- Have it handy when you call. What it pays depends on its own terms, including any waiting period.
- If you don't
- Start with your options to pay for home care, set side by side.
- If the question is Medicare
- Read Medicare’s home care coverage rules before you plan around them.
- If care is needed around the clock
- The monthly cost of 24/7 in home care explains what shapes the cost.
Call with the policy or without it
The first conversation is free either way and runs about the same length. Having the policy handy lets us answer more of your questions about it.
| With the policy in hand | Without it yet | |
|---|---|---|
| What gets read | The benefit page, line by line, against the schedule being planned | The help you're planning, with the policy question kept for later |
| What to have handy | The policy, and any rider or endorsement pages with it | Nothing at all |
| What it costs | No charge | No charge |
Either way, you can ask us to call you, or call our care team at (203) 936-6847 with whatever question is on your mind.
Questions families ask about coverage
Does long term care insurance cover home care?
Often, yes. The NAIC notes individual long term care insurance policies often cover home health care, adult day care, and assisted living in addition to nursing home care. Most health insurance doesn't cover daily-living companion or personal care, but a long term care policy may. Check your policy's terms, including any pre-existing condition waiting period, usually six months.
Will my health insurance pay for a companion or personal care aide?
Usually not. Most health insurance plans don't cover daily-living companion or personal care, though a long term care insurance policy may. Medicare and most health insurance, including Medigap, don't pay for daily-living long term care either.
Can Endurance help me use my long term care insurance policy?
Yes. Families with a long term care insurance policy can use it for care with Endurance, and families sit down with the founders to review coverage. We help with the policy paperwork, and what a policy pays depends on its own terms. One family wrote on AgingCare: 'When I met with Tom and Chris, we discussed our LTC policy and my stress level was very much reduced.'
Most families have never opened the benefit page.
That’s the whole reason to open it with somebody. Tell us what’s happening at home and whether there’s a long-term care insurance policy. We’ll talk through the care plan with you and help with the policy paperwork, from an agency licensed in Connecticut and New Jersey. The first conversation is free, and nothing starts until you say so.