A common question consumers ask is, "How do I qualify for my Long Term Care benefits?"  

Long Term Care Insurance and Activities of Daily Living (ADL's)

Once you begin needing help or supervision with your activities of daily living (ADL's), you may be eligible for your Long Term Care Insurance benefits.  It is up to your doctor to certify your need for Long Term Care. 

A common set of ADL's is used to determine your need for Long Term Care.  These activities of daily living are eating, bathing, dressing, toileting, transferring, and maintaining continence. 

The exact details regarding ADL's can be found in your Long Term Care policy, so be sure to read about qualifying for benefits.  Most Long Term Care Insurance policies will pay benefits when you can no longer perform two of six ADL's. 

The top Long Term Care Insurance companies (such as Genworth Financial, John Hancock, MetLife, Mass Mutual, and NY Life) will pay for both physical and standby assistance.  Physical assistance would occur when you need physical help with ADL's, whereas standby assistance would occur when you need supervision with ADL's (to make sure you can perform them safely).

Cognitive Impairment

Conditions such as Alzheimer's or dementia can also trigger Long Term Care Insurance benefits.  Cognitive impairment can cause a person to need supervision to prevent them from leaving the stove on, for example, or from roaming the neighborhood.  Although the person might not need someone to help them physically, they need supervision to make sure they are safe. 

Prior Hospitalization

Policies sold today do not require prior hospitalization to start benefits. However, Medicare still requires a three-day hospital stay to be eligible for Medicare payment of skilled nursing facility benefits.