See how much home care your policy covers
Don't let the fine print keep you from using the policy you invested in.
Long-Term Care Benefit Estimator
Answer what you know. If you are not sure about something, just pick Not sure. We will show you what it could mean either way. Nothing is sent anywhere unless you ask us to.
What we found
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We read these policies every week. We are happy to look at yours and tell you what it covers.
These are estimates based on what you entered. They are not a quote, and they are not insurance advice. Only your insurance company can tell you for sure what your policy covers.
Four things decide what your policy pays
Most of the surprises come from these four. Here they are in plain English.
How much it pays
Every policy has a limit. Some pay up to a set amount each day. Others pay up to a set amount each month. Knowing which one you have helps you set up a schedule that gets the most out of it.
The waiting period
Most policies ask you to pay for care yourself for a while before they start paying. Ninety days is common. Some count every day on the calendar. Others only count the days a caregiver comes.
The wait does not start until care starts
This catches a lot of people. The clock does not start when you file the claim. It starts when a caregiver walks in the door. So do not wait on the insurance company. We start care right away and work on the claim at the same time.
How much is left
Many policies grow a little each year. The amount left is often bigger than the number people remember. It is worth checking before you plan anything.
How the waiting period works
If there is one part worth understanding, it is this one. Most of the costly mistakes happen here.
It works like a deductible, but it is counted in days
During the waiting period, you pay for care yourself. After it ends, the policy starts paying. Ninety days is the most common length. Your policy may call it the elimination period.
Not every policy counts days the same way
Some policies count every day on the calendar. Care starts January 1, and with a 90-day wait, the policy starts paying around April 1.
Other policies only count the days a caregiver actually comes. If a caregiver comes three days a week, it takes almost six months to reach 90 days.
It is the same 90-day policy either way, but the wait can be twice as long. One phone call tells you which kind you have, and we are glad to make that call with you.
The clock starts when care starts
This is the part that costs families the most money.
Your waiting period does not start when you get sick. It does not start when you file the claim, either. It starts the day a caregiver actually shows up.
So if you wait for the insurance company to say yes before you get help, the clock is not running. Families lose weeks and sometimes months this way.
Do not wait on your claim
If your mom or dad needs help now, get them help now. We start care right away and work on the claim at the same time. That way the waiting period is already counting down while the paperwork is still moving.
More visits often beats longer visits
This surprises people, and it can save a lot of money.
Say your policy pays up to a set amount each day. If you get 20 hours of help a week in two long visits, each of those days may cost more than the policy allows. You would pay the difference every week.
Spread those same 20 hours over five shorter visits, and each day may fall under the limit. It is the same amount of help at the same total cost, but the policy covers more of it.
There is a limit to this. Visits under four hours cost more per hour, so they use up the policy faster. Four hours is usually the sweet spot, and the tool above will not suggest anything shorter.
You may have already finished the waiting period
Almost nobody checks this, and it is worth checking.
Maybe your mom or dad has been paying for care already. Maybe they spent time in rehab or a nursing home. Some of those days may already count toward the waiting period. Some insurance companies will give you credit for them. None of them will bring it up on their own.
We have seen families finish the waiting period long ago and never find out. If a policy has been sitting in a drawer while you paid out of pocket, one phone call is worth making.
Ten things worth knowing before you file
- Start care before the paperwork is done. The waiting period does not start until a caregiver is coming. Waiting to sort out the insurance first can cost you months.
- Ask three questions about the waiting period, not one. How many days? Does it count every day, or only days a caregiver comes? And does it start from your first day of care, or the day you filed? That middle question can be worth months.
- Do not go by the number on the old policy. Many policies grow every year. Ask the insurance company what it pays today.
- Find out if it pays by the day or by the month before you set a schedule. It changes what gets covered.
- Ask if any days already count. Care you have paid for, a rehab stay, or a nursing home stay may count toward the waiting period. You have to ask.
- Most policies want a licensed agency. A caregiver you hire on your own usually will not qualify, no matter how good they are. Claims get turned down for that reason alone.
- Most claims are not turned down because care is not needed. They are turned down over paperwork. A missing form. The wrong wording. A late filing. Fix the paperwork and most of them go through.
- Be careful with an "Alternative Plan of Care." Some companies offer one as a helpful option. It can quietly give you less than you paid for. Have a lawyer read it first.
- A policy that lapsed may not be gone. If a payment was missed because of memory trouble, the policy may be able to come back. Ask an elder law attorney.
- Keep paying the premium. Most policies keep charging you right through the waiting period.
A few things that matter here in Ohio
An Ohio Partnership policy can protect your savings
Ohio takes part in a program called the Long-Term Care Partnership. If your policy is part of it, every dollar the policy pays out is a dollar of savings the state will not count if you ever need Medicaid. It also protects that much from being claimed back from the estate later.
Here is what people miss: using the policy actually protects more of your savings. Letting it sit unused does the opposite. If you are working with an elder law attorney, bring this up.
Not every policy is part of the program. Ask your insurance company if yours is.
Ohio licenses home care agencies, and your policy may require one
Since 2022, Ohio has required home care agencies to be licensed by the Ohio Department of Health.
This matters more than it sounds. Most policies will only pay for care from a licensed agency. A caregiver you hire on your own usually will not count, no matter how kind or skilled they are, and the claim gets turned down for that reason alone.
Visiting Angels Columbus West is a licensed Ohio home care agency. We put our license number right on the claim.
Your insurance company may have stopped selling policies. It still has to pay yours.
Genworth, John Hancock, MetLife, Prudential, Transamerica and MassMutual all stopped selling new long-term care policies. That worries people, and it should not. It does not change the policy you already have. It is a contract, and the industry paid out about $16.8 billion in claims in 2024 alone.
What has changed is the claims process. These companies look at claims very closely and they are strict about the rules. That is not a reason to give up on your policy. It is a reason to file it right the first time. That is the part we handle.
Your benefits may have changed without you noticing
Over the years, a lot of policyholders were given a choice: pay a much higher premium, or keep the premium the same and take smaller benefits. Many people picked the second one. Sometimes years ago. Sometimes a spouse handled the paperwork.
So the policy in the drawer may not match the policy you actually have. Get the current numbers in writing before you plan around anything.
If your insurance company went under, the policy may still be worth something
Ohio has a safety net called the Ohio Life and Health Insurance Guaranty Association. It covers long-term care policies when an insurance company fails.
There is a limit to what it pays, and many older policies are worth more than that limit, so it may not cover everything. If your insurance company failed, talk to an elder law attorney before you assume the worst.
Medicare will not pay for this
Medicare pays for short-term skilled care at home after a hospital stay, under a doctor's order. It does not pay for the everyday help that keeps someone at home: bathing, dressing, meals, company, someone keeping an eye on things.
Ohio Medicaid can help through programs like PASSPORT, but you have to spend down to about $2,000 in savings first. That is exactly what a long-term care policy is meant to prevent, which is why letting one go unused is such an expensive mistake.
We handle the insurance part
You should not have to become an expert on your own policy. That is our job, and we do it every week.
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We read the policy, for free
Send it to us. We will send back a one-page summary in plain English. What it pays now. How long the wait really is. What you will owe in the meantime. How long the money lasts.
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We call the insurance company with you
We get on the phone and ask the questions that decide the claim, including the ones most families do not know to ask.
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Care starts right away
We do not wait for approval to start helping. A caregiver comes, and the waiting period starts counting down while the paperwork is still moving. Every visit gets logged, with notes. That record is what gets claims paid.
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We handle the claim every week
Invoices, care notes, forms, follow-up, and appeals if it comes to that. If your policy allows it, the insurance company can pay us directly, so you are not paying up front and waiting to get paid back.
Already one of our families?
If there is a policy sitting in a drawer, tell us. We have a record of every day of care we have given. Sometimes the waiting period is already behind you and nobody ever said so. Call 614-538-1234 and ask us to look.
Have a client with a policy?
If you work with older adults in Central Ohio, you have met the family holding a policy nobody knows how to use. Send them our way. It costs them nothing, we do not sell insurance, and we are not competing with you.
Insurance agents and brokers
You sold the policy. Now your client is 78 and calling to ask how to use it. You are not a claims department, and you should not have to be. We do the review, the phone call, and the claim. And when we meet a family with no coverage, we send them to you.
Elder law attorneys and fiduciaries
If the policy is part of the Ohio Partnership program, using it well protects your client's savings. We build the records, the care plan, and the claim that make that happen. And we send anything legal back to you.
Advisors, trust officers and care managers
An unused policy means the portfolio is paying for care it never should have touched. We get the benefit turned on and give you a clear written record of what it covers and how long it will last.
Let us take a look at your policy
Send us the policy and we will read it. You will get back a short summary in plain English: what it pays, when the payments start, and what you will owe in the meantime. You do not have to hire us to get it.
Someone in our Columbus office answers the phone. We return every call within 15 minutes, day or night.