Ways to pay · California
Long-term care (LTC) insurance policies were designed specifically to cover the costs of assisted living, memory care, in-home care, and skilled nursing. But policies vary significantly — in daily benefit amounts, elimination periods, covered care types, and inflation protection. Understanding your policy before choosing a facility can save families significant money and avoid unexpected out-of-pocket costs.
The waiting period — typically 30, 60, or 90 days — before your policy begins paying. During the elimination period, you pay for care out of pocket. Think of it like a deductible measured in time rather than dollars.
The maximum your policy pays per day of care — often $150–$300 for older policies, more for newer ones. If your facility costs $250/day and your benefit is $200/day, you pay the $50/day difference.
How long the policy will pay — often 2, 3, or 5 years, or lifetime. The total benefit pool = daily benefit × benefit period. Policies with longer benefit periods cost more but provide more protection.
Some policies include automatic inflation riders (3–5% annual increase) that protect your benefit from being eroded by rising care costs. Check whether your policy has this — it significantly affects long-term value.
Most policies also require a certification of disability — a licensed healthcare provider must certify that your parent cannot perform at least 2 ADLs (activities of daily living) or has a cognitive impairment. This is the trigger for benefits to begin.
Find the policy document and identify: insurance company, policy number, daily benefit, elimination period, benefit period, and covered care types.
Contact the insurance company to open a claim. They will request a care needs assessment from a licensed healthcare provider — typically a physician or nurse.
Pay out of pocket for care during the elimination period (30–90 days), then submit documentation to begin receiving benefits.
Jagua can help you understand how your policy applies to specific facilities you're considering — and identify facilities that work smoothly with LTC insurance billing.
