A Guide To Understanding Long-Term Care Elimination Days

Long-term care elimination days are an essential aspect of long-term care insurance policies, but many people may not understand what they are or how they work. Elimination days is a specific number of days that must pass before your long-term care insurance coverage begins to pay for your care.

Here are some of the details of long-term care elimination days patients and caregivers should know. We will cover how working with an independent, board certified patient advocate can help understanding and utilizing elimination days effectively.

Additionally, we will provide tips on choosing the right elimination day period for you and the consequences of not having enough coverage during this waiting period.

What Are Long-Term Care Elimination Days?

Long-term care elimination days, also known as the “waiting period” or “qualifying period”, are a specific number of consecutive days that you must pay for your long-term care expenses before your insurance coverage kicks in. It is similar to a deductible in other types of insurance policies, but there are significant differences.

Elimination days typically range from 0 to 180 days, with longer periods resulting in lower premium payments. During this waiting period, you will be responsible for covering the cost of your own care until the elimination day requirement is met. Once it is met, your policy will begin paying for a portion or all of your long-term care expenses.

It’s important to note that not all long-term care insurance policies have an elimination day requirement. Some policies may have a “first dollar coverage” feature, where the insurance coverage begins immediately without any waiting period. However, these policies usually come with higher premiums.

How Do Elimination Days Differ from Deductibles?

While elimination days and deductibles may seem similar, there are significant differences between the two. A deductible is a fixed amount that you must pay out of pocket before your insurance coverage begins to cover the remaining expenses. In contrast, an elimination day is a specific number of days that must pass before your policy kicks in.

Another difference is that with most insurance policies, once you meet the annual deductible, you will not have to pay it again until the next year. But with long-term care insurance, you will have to meet the elimination day requirement each time you need care.

In some insurance policies, you can choose your deductible amount, but you cannot choose your elimination day period. It is predetermined by the policy and usually ranges from 0 to 180 days.

Factors That Can Affect Elimination Days

Several factors can affect the length of an elimination day period in a long-term care insurance policy. These include:

  1. Policy Type: As mentioned earlier, some policies may have a “first dollar coverage” feature, eliminating the need for an elimination day requirement. Additionally, some policies may have a shorter elimination day period than others. Policies that include inflation protection may have longer elimination days. Policies that cover home care may have shorter elimination days.
  2. Premium Cost: Generally, policies with longer elimination day periods come with lower premiums. If you choose a policy with a short or no elimination day period, it can result in higher premiums.
  3. Age at Purchase: The age at which you purchase your long-term care insurance policy can also affect the length of the elimination day period. Older individuals may be subject to longer waiting periods than younger individuals.
  4. Health Status: Your health status at the time of purchasing the policy can also impact the length of the elimination day period. Individuals with pre-existing conditions may have longer waiting periods, while those in good health may have shorter ones.
  5. Inflation Protection: As mentioned earlier, policies with inflation protection may have longer elimination day periods to account for the increasing cost of long-term care services.

Choosing the Right Elimination Day Period

When choosing a long-term care insurance policy, it’s important to consider the elimination day period carefully. While a shorter waiting period may seem appealing, it can result in higher premiums that may not be sustainable in the long run.

On the other hand, a longer elimination day period can significantly lower your premiums but also means you will have to cover more out-of-pocket expenses before your policy kicks in. It’s crucial to assess your financial situation and choose an elimination day period that is reasonable for you.

Also, consider your age at the time of purchasing the policy and any potential health issues that may arise in the future. These factors can affect how long you may need care and therefore impact your decision on the length of the elimination day period.

How Working With A Patient Advocate Can Help

Navigating the complexities of long-term care insurance can be overwhelming, especially when it comes to understanding and utilizing elimination days effectively. This is where a board-certified, independent patient advocate like Stevie from Seawind Health Advocacy Group can make a significant difference. Here’s how a patient advocate can help:

Guiding You Through the Elimination Period

Elimination days are the initial days during which you must pay for your care out-of-pocket before your long-term care insurance benefits kick in. Understanding which services and appointments count toward these elimination days is important. A patient advocate can:

  • Clarify Policy Details: Review and explain the specifics of your long-term care policy, including what types of services are eligible to count toward elimination days.
  • Identify Eligible Services: Help you identify which medical and therapy services can be scheduled during this period to maximize the counting of elimination days.
Identify Eligible Services that count toward long term care elimination days

Efficient Scheduling of Appointments

Maximizing the effectiveness of your elimination days often involves strategic scheduling of multiple appointments on the same calendar date. A patient advocate can assist by:

  • Coordinating Appointments: Assist in scheduling various therapy, treatment, and follow-up appointments on the same day. This approach ensures that each visit counts toward your elimination days, potentially accelerating the process.
  • Liaising with Providers: Communicate with your healthcare providers to coordinate appointment times and ensure that all necessary services are received on the planned dates.
  • Creating a Plan: Develop a comprehensive plan that aligns with your policy requirements and personal healthcare needs, ensuring that you are receiving the appropriate care while efficiently utilizing your elimination days.

Ensuring Documentation and Compliance

Proper documentation is essential for ensuring that all eligible services count toward your elimination days. A patient advocate can:

  • Assist with Paperwork: Help you complete and organize all necessary paperwork and documentation required by your insurance company.
  • Track Progress: Monitor and track the completion of your elimination days, keeping you informed about your progress and remaining requirements.
  • Advocate on Your Behalf: Communicate with your insurance company to ensure that all eligible services are accurately accounted for, resolving any issues or discrepancies that may arise.

Providing Comprehensive Support

Beyond just managing elimination days, a patient advocate offers comprehensive support throughout your healthcare journey. This includes:

  • Attending Doctor Appointments: Accompany you to doctor appointments, ensuring that you fully understand your treatment plans and that all questions are addressed.
  • Managing Claims: Assist with filing and managing insurance claims, reducing the burden of administrative tasks and ensuring that you receive the benefits to which you are entitled.
  • Ongoing Guidance: Provide continuous support and guidance, helping you navigate the healthcare system and make informed decisions about your care.

Contact Us For A Better understanding and efficient management of long-term care elimination days

For when you need the peace of mind in knowing that your best interests are being prioritized, contact board certified patient advocate Stevie Kiziukiewicz. You’ll receive personalized guidance and advocacy for all your complex healthcare situations.

We understand the importance of planning for your future and ensuring quality care should you need it. That’s why we offer support for patients, providing education on medical and legal decisions, and advocating for patient safety.

long term care insurance elimination days new jersey

Working with a patient advocate like Stevie can significantly enhance your understanding and management of long-term care elimination days, ensuring that you receive the best possible care while maximizing your insurance benefits. With expert guidance, efficient scheduling, and comprehensive support, you can focus on your health and well-being, confident that your long-term care needs are being effectively managed.

call 732-245-0210 or contact us for a New Jersey
Patient Advocate consultation


Do all long-term care insurance policies have an elimination day period?

No, not all policies have an elimination day period. Some may offer immediate coverage without a waiting period, but this often results in higher premiums.

Can I change the length of my elimination day period after purchasing a policy?

In most cases, no. The elimination day period is typically set when you purchase the policy and cannot be changed later on.

Are there any other factors that can affect the length of the elimination day period?

Yes, some policies may also consider your occupation and where you plan to receive long-term care services when determining the length of the waiting period.  Additionally, any discounts or special offers from insurance companies could also impact the duration of your elimination day period.  It’s important to carefully review all aspects of a policy before making a decision.

Is long-term care insurance the only option for covering long-term care expenses?

No, there are other options such as setting aside personal savings or investing in a hybrid life insurance policy with a long-term care rider. Each individual’s situation is unique, and it’s essential to consult with a professional before making any decisions regarding long-term care planning.