A client’s ability or lack thereof to perform various activities of daily living (ADLs) is the most common criteria used by insurance companies to decide whether a client is eligible for benefits. ADLs most commonly used are bathing, dressing, eating, using the bathroom, and transferring. Typically, a long term care policy pays benefits based on the clients ability to do a certain number of the ADLs, such as two out of six or three out of six. The six activities of daily living (ADLs) have been determined through years of careful scientific research. Interestingly, this and other research has shown that bathing is usually the first ADL that a person becomes unable to perform without assistance. While most long term care home care policies use all six ADLs as benefit triggers, qualifying for benefits from a policy that uses five ADLs may be more difficult if bathing is the omitted ADL. Therefore, always make sure to ask your insurance company what the ADLs are under your policy.

Elimination, or waiting, period is a type of deductible. It is defined as the length of time the long term home care plan holder must pay for covered home care services before the insurance company will begin to make payment. The longer the elimination period the lower the premium will be, so check with your long term care insurance company regarding your plan’s elimination period.