Long-Term Care Insurance Claims: Part 3 – What is Care Giver Eligibility?

“Long Term Care Insurance Claims

– The Basics”

Long Term Care Claims help

What is Care Giver Eligibility?

All-cash and part-cash long-term care policies (i.e. policies where the benefit is paid in cash) do not require a licensed care provider. However, reimbursement long term care insurance policies – most policies are this type – often do require a licensed care provider. So if the contract specifies a licensed provider this means it will not pay family or neighbors to be care providers….unless they are properly licensed.

In many states, home health care providers are not licensed by the state. There are some work-arounds on this issue that work occasionally. This can vary by long term care insurance carrier. In general, if you have a company that is properly licensed at the State level for Medicare services or Medicaid services, you have one that is “properly” licensed.

The issue is less problematic for assisted living as most states have a specific assisted living licensure process. The problem is non-existent in nursing homes as these are required in every state to be licensed by the state.

So care giver eligibility for long term care insurance claims is dependant on the licensing of the care giver and the facililty.


Some Additional Links to help you with your long term care claim journey

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