Calendar-Day Elimination Period
Every calendar day can count once the policy's conditions for the elimination period are met, whether or not paid covered care is received every day.
Direct Answer
How the Elimination Period Works
An elimination period works like a waiting period before long term care benefits begin. You can meet the policy's benefit trigger and still have to satisfy the elimination period before the insurer starts paying.
The period is stated in days. Depending on the contract, those days can be counted as calendar days or service days.
How Days Are Counted
Calendar Days vs Service Days
Service-Day Elimination Period
Only days on which qualifying covered services are received may count. A 90-day service-day period can therefore take longer than 90 calendar days to satisfy.
This distinction can materially change a claim. Two policies can both say 90-day elimination period and produce very different out-of-pocket exposure depending on how the days are counted.
Premium Tradeoff
How the Elimination Period Affects Cost
A longer elimination period generally shifts more of the early care cost to you and can reduce the insurance premium. A shorter elimination period can provide benefits sooner but generally costs more.
Shorter Waiting Period
Higher potential insurer exposure at the beginning of a claim, which can increase premium.
Longer Waiting Period
You retain more of the initial care risk, which can lower premium.
Self-Funding Layer
Cash, income or other assets should be available to cover care during the waiting period.
Policy Review
What Should You Verify in the Contract?
- How many days the elimination period lasts
- Whether it uses calendar days or service days
- Whether home care and facility care use the same waiting period
- Whether the elimination period must be satisfied once or more than once
- Whether days need to be consecutive
- What documentation is required before a day counts
Common Questions
Frequently Asked Questions
Is the elimination period the same as a deductible?
It serves a similar risk-sharing purpose, but it is usually measured in time rather than dollars.
Does a 90-day elimination period always mean benefits start on day 91?
No. It depends on how the policy counts days and whether all claim requirements have been satisfied. A service-day definition can take longer than 90 calendar days.
Does the elimination period start when I buy the policy?
No. It generally becomes relevant when you have a qualifying claim and satisfy the policy conditions for beginning the elimination period.
Related Long Term Care Topics
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Compare the benefit structure, underwriting, elimination period, inflation protection and premium before deciding which type of long term care coverage fits your plan.
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Educational Disclaimer
This information is for general educational purposes and is not individualized insurance, legal, tax, investment or financial advice. Product features, underwriting, premiums, benefit triggers, riders and availability vary by insurer, state and individual circumstances. Review the actual policy before purchasing coverage.
