Paying for Care
Long-term care insurance claims for dementia
If your loved one has an old LTC policy, dust it off. Most policies were sold in the 80s and 90s and have generous benefits — but the claim process is intentionally complicated.
Updated 2026-02-20
Documenting the benefit trigger
- Most policies pay when the insured needs help with 2+ ADLs (bathing, dressing, eating, toileting, transferring, continence) OR has severe cognitive impairment.
- Get a physician's letter listing specific ADL deficits.
- Most policies require a 30–90 day "elimination period" before payments start.
- Some policies require care be delivered by a state-licensed agency.
Common rejection reasons
- Documentation isn't specific ("needs help" vs "unable to independently dress without verbal cues").
- Care delivered by family member when policy requires licensed agency.
- Daily caregiving log not maintained.
- Failure to invoke the policy in writing within stated timeline.
Frequently asked questions
- Should I hire someone to help with the claim?
- Often yes. Specialized claim consultants charge a fee but understand the rejection patterns.
Every dementia journey is different.
Memory Lane Care helps you understand what applies to your loved one, what to expect next, and which resources fit your family's situation.
Related across the journey
Memory Lane connects every part of dementia care. Here's how this topic threads into the rest.
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