Understanding long-term care insurance benefits in PA.

If your loved one bought a long-term care policy years ago, there’s a good chance it’s better than they remember — and a real chance no one has ever helped them activate it. We do this every week. Here’s the version we wish more Pennsylvania families had.

What LTC insurance actually covers

Most LTC policies sold between 1990 and 2015 cover home care — not just nursing facilities. Many policyholders don’t realize this. The benefit kicks in when the policyholder needs help with two or more “activities of daily living” (ADLs): bathing, dressing, toileting, eating, transferring, and continence. Most policies also trigger on cognitive impairment alone.

Coverage typically pays a daily or monthly maximum — common ranges in PA are $150–$300/day for home care, after a 30-, 60-, or 90-day “elimination period” (during which you pay out of pocket).

The five questions to ask your policy

1. What’s my daily benefit? The number on page one of your policy summary.
2. What’s my elimination period? The waiting days before benefits start. Older policies often have 90; newer ones, 30 or zero.
3. Does it have inflation protection? If yes, your daily benefit grows over time — important if the policy was bought 20 years ago.
4. Are home care benefits at 100% of the daily benefit, or a percentage? Some policies pay 50–80% of the daily benefit for home care vs. 100% for facility care.
5. Is my agency required to be licensed? Yes, in PA — and Rittenhouse is. We provide all the documentation insurers require.

Common Pennsylvania-specific notes

• PA is a Partnership state. If your policy is “Partnership-qualified,” it offers asset protection from Medicaid spend-down — a significant detail if facility care later becomes part of the picture.
• Tax deduction. LTC premiums are deductible on your PA return up to certain limits depending on age. Worth a five-minute conversation with your accountant.
• Veterans coverage stacks. If your loved one served, VA Aid & Attendance benefits can run alongside LTC insurance — they’re not mutually exclusive.

What to do this week

1. Find the original LTC policy — usually a 30–60 page bound document. Photograph the first three pages (summary).
2. Call the carrier’s claims line (on the policy) and request a current “benefit summary” letter.
3. If care is starting soon, call us. We’ll review the policy with you and tell you exactly what to file.

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This article reflects our experience supporting families with LTC claims and is not financial or legal advice. Your individual policy terms govern. We’re happy to review your policy alongside your financial advisor.