How to Use Long-Term Care Insurance for Home Care

If your loved one has long-term care (LTC) insurance, it may help cover the cost of home care services in Boca Raton, Delray Beach, Boynton Beach, and throughout Palm Beach County. Many families are unaware that their policy can be used for in-home care instead of assisted living or nursing facilities.

When Does LTC Insurance Cover Home Care?

Most policies activate when a person:

• Needs help with at least two Activities of Daily Living (ADLs) such as bathing, dressing, or transferring

  OR

• Has a cognitive impairment such as Alzheimer’s or dementia.

A physician’s certification is typically required, and some policies request a nurse assessment.

How Long-Term Care Insurance Reimbursement Works

Most policies operate under a reimbursement model:

1. Home care services are provided.

2. The family pays the agency.

3. Required documentation is submitted.

4. The insurance company reimburses up to the policy’s daily or monthly benefit limit.

Policies often include a 30–90 day elimination period, during which care must be documented but is paid out-of-pocket.

Why Proper Documentation Matters

Insurance companies require:

• Physician certification

• A detailed care plan

• Itemized invoices

• Daily caregiver notes showing ADL assistance

Clear, accurate documentation prevents delays and claim denials.

Home Care in Palm Beach County

Using long-term care insurance allows seniors to:

• Remain safely at home

• Maintain independence

• Avoid premature facility placement

• Receive personalized, one-on-one care