When Will I Begin Receiving Benefits?


When Will I Begin Receiving Benefits?


Benefits Begin When... Your Elimination Period is satisfied!

Most policies have an elimination period (sometimes called deductible or a waiting period). This means benefits can start 0, 20, 30, 60, 90 or 100 days after you start receiving long-term care or become disabled. How many days you have to wait for benefits to start will depend on the elimination period you pick when you buy your policy. Choices above may not be available with all carriers. Some policies have the option of a 0-day elimination period, but expect it will cost more. The shorter the elimination period is the greater the premium. You will be responsible for the paying your own care during the elimination period.

Types of Elimination Periods Offered

  • Calendar Day Elimination Periods:

    • Every day of the week would count in determining the elimination period regardless of whether you received any services on those days. You could be getting only one or two days a week of care and still have your elimination period satisfied 30 days from the date you qualify as eligible.

    • Easiest to satisfy care requirement.

    • May be more expensive

  • Service Day Elimination Periods:

    • Only days when you receive services will count toward the elimination period.

    • If you receive care 3 days a week, it would take you 10 weeks to satisfy your elimination period.

    • Will Cost you more in care while satisfying your elimination period than Calendar Day.

  • One For Seven:

    • If you receive one day of care per week... it satisfies 7 days towards your elimination period. Usually the One for Seven is a built in feature.

Case Example:

You Have a 30 Day Elimination Period with $150 Daily Benefit. On 9/1/2008 you are determined by a physician to be unable to perform 2 of the 6 ADLs with a condition that is expected to last more than 90 days. This means your elimination period can begin.

If you have a product that has:

  • Calendar Day Elimination Period: You can expect to begin receiving benefits on 10/1/2008.

  • Service Day Elimination Period: You will have to receive 30 days of qualified services before your benefits begin. If you receive services 3 days a week, it would take you 10 weeks to satisfy your elimination period. Remember you are responsible for those service fees during the elimination period.

  • One For Seven Elimination Period: You could be receiving 1 day of care for 2 hours a day and satisfy a 30 day elimination period in 5 weeks with only paying for 2 hours of care a week / 10 hours of care in total.

Satisfaction of Elimination Period methods available:

  • Once In Your Lifetime: You only have to satisfy the elimination period once in your lifetime. If you become sick, meet the long-term care eligibility (unable to do 2 of 6 Activities of Daily Living), require care, and then rehabilitate to where you no longer need care... those days would count toward your elimination period.

  • Each "Episode of Care": You have to satisfy the elimination period with each episode of care. If you become sick, meet the long-term care eligibility (unable to do 2 of 6 ADLs), require care, and then rehabilitate where you no longer need care... those days would not count toward your elimination period. You would have to re-start your elimination period should you meet the long-term care eligibility requirements.


Disclaimer: Insurance products are offered through insurance companies with which we have sales arrangements. Not all products/features may be available in your state. Check with your Accountant or Tax professional on the tax issues associated with Long-Term Care insurance purchase and benefits. Associates of Clifton Park are not a part of Raymond James & Associates. Securities offered through Raymond James & Associates, Inc. Member FINRA/SIPC

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