The elimination period is the waiting period between when you first qualify for long-term care benefits and when your policy begins paying. Understanding how it works — and how to choose the right one — can significantly affect both your premium and your out-of-pocket costs at claim time.
What Is an Elimination Period?
Think of the elimination period as the deductible of your long-term care policy — expressed in time rather than dollars. Once you have a qualifying disability (unable to perform two of six ADLs, or diagnosed with cognitive impairment), you must satisfy the elimination period before the insurance company begins paying benefits.
During the elimination period, you are responsible for your own care costs. The length of the elimination period you choose directly affects your premium: a longer elimination period lowers your premium; a shorter one raises it.
Common Elimination Period Options
0 Days
Benefits begin on day one of a qualifying claim. Highest premium but no out-of-pocket waiting period costs. Less commonly purchased due to cost.
30 Days
Benefits begin after 30 days of qualifying care. Reasonably short waiting period with a moderate premium reduction compared to a 0-day option.
90 Days (Most Common)
The most popular choice. Offers a meaningful premium discount while limiting out-of-pocket exposure to approximately 3 months of care costs. A good balance for most buyers.
180 / 365 Days
Lowest premiums but significant self-insured period. At current costs, 180 days of nursing home care could mean $55,000–$65,000 out of pocket before benefits begin. Best for those with substantial liquid assets.
How the Elimination Period Is Counted
Carriers differ in how they count days toward satisfying the elimination period — and the difference matters:
Zero-Day Elimination Period for Home Health Care
Many policies offer a zero-day home health care rider that waives the elimination period specifically for in-home care services — even if the nursing home elimination period is 90 days. This is a valuable rider because:
- Most people prefer to receive care at home rather than in a facility
- Home care needs often arise before nursing home placement
- Days of home health care received may count toward satisfying the nursing home elimination period if facility care is later needed
At current national rates, 90 days in a semi-private nursing home room costs approximately $27,750 out of pocket. Factoring in this exposure when selecting your elimination period is an important part of planning.
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