Long-term care insurance (LTCI) is a type of insurance policy designed specifically to pay for the kind of care that Medicare does not cover, personal care, companion care, home health aide services, and residential care. Millions of Americans have these policies. Many never use them, or use them later than they could have.

This guide is for families in Northeast Atlanta who suspect a parent or spouse may have an LTCI policy, or who have confirmed one exists but are not sure how to activate it.

How to determine if a policy exists

Many older adults purchased LTCI policies in the 1990s and 2000s during a period when financial advisors widely recommended them. If you are unsure whether a policy exists, check through the following:

  • File cabinets and document storage for policy documents
  • A financial advisor or insurance broker your parent worked with
  • Annual insurance statements sent by mail or email
  • The National Association of Insurance Commissioners (NAIC) offers a policy locator service
  • Safe deposit boxes, many people store policies there

When benefits typically begin: the elimination period

Most LTCI policies have an elimination period, a waiting period before benefits begin. This period commonly ranges from 30 to 90 days. Think of it like a deductible measured in time rather than dollars: during the elimination period, you pay for care out of pocket, and benefits begin after that period ends.

Understanding the elimination period is critical for planning: if a policy has a 90-day elimination period and care begins in January, benefits may not start flowing until April. Families need to plan for that gap.

Benefit triggers: what qualifies you for benefits

Most LTCI policies pay benefits when the insured person requires assistance with two or more Activities of Daily Living (ADLs) — bathing, dressing, toileting, transferring, eating, or continence, or when they have a cognitive impairment (dementia) that requires substantial supervision. A physician's certification is typically required.

This is where many families in Atlanta leave money on the table: they wait until a loved one needs help with many ADLs before filing a claim, when in fact a physician's documentation of two ADL limitations, or a dementia diagnosis, may be sufficient to trigger benefits immediately.

Filing the claim: what insurers typically require

To initiate an LTCI claim, you will typically need:

  • A physician's assessment documenting the ADL limitations or cognitive impairment
  • A care plan developed by a licensed care professional (HomeWell's Care Managers prepare this documentation routinely)
  • An assessment from the insurance company's own care manager (most insurers send one)
  • Ongoing documentation, invoices, care logs, to receive continued benefit payments

How HomeWell works with LTCI carriers

HomeWell works directly with most major long-term care insurance carriers operating in Georgia, including Genworth, John Hancock, Transamerica, Mutual of Omaha, and others. We prepare the care plan documentation, submit invoices in the format carriers require, and communicate with care coordinators on the insurer's side.

Families do not have to navigate this alone. Our goal is to ensure that if a policy exists, it is being used, and that benefits flow as quickly as possible after the claim is filed.

What if the policy is from a company that is no longer writing new business?

Several major LTCI carriers have exited the long-term care insurance market in recent years. However, existing policies remain in force and claimable, the insurer may be in runoff, but the obligation to pay legitimate claims remains. If you have difficulty reaching an insurer for a parent's policy, your state insurance commissioner's office can assist.