Have a Long-Term Care Insurance Policy? Here's How It May Help Pay for Home Care in New Jersey

Is there a long-term care insurance policy sitting in a drawer at your house or your parents' house?

It may be worth more than you realize.

Families can pay premiums for years and then never use their benefits when care is actually needed. Some don't realize their policy may cover care at home. Others get a claim packet, see all the paperwork involved and don't know where to start.

At BrightStar Care of Middlesex, Monmouth, Passaic and Western Bergen Counties, we see it all the time. A family calls us about care for Mom or Dad, and somewhere in the conversation someone says, "Wait, I think she has a long-term care policy." That one sentence can change how a family pays for care.

Here's what New Jersey families should know about using long-term care insurance for home care, the questions to ask your insurance company, and how BrightStar Care can help once a claim is opened.

Does long-term care insurance cover home care?

Many policies do, but not all of them. Some older policies were written mainly for nursing home care. Many newer policies also cover care at home, including help from a certified home health aide or a nurse.

If your policy includes home care benefits, it may cover a significant portion of the cost of having a caregiver help your loved one remain safely at home.

The only way to know for sure is to call your insurance company. Your policy and your carrier have the final word on what is covered, how much it pays and when benefits begin.

Checklist: Questions to ask your insurance company

Start by pulling the policy out of the drawer. Then call the carrier's claims line and work through these questions.

• Does my policy cover care at home? Ask whether it covers personal care from a home health aide as well as skilled nursing.
• What is the elimination period? This is the waiting period before benefits begin, often 30, 60 or 90 days. Ask whether it counts every calendar day or only the days you receive paid care.
• What is the daily or monthly benefit? This is the most the policy will pay for a day or a month of care.
• Is there a lifetime benefit maximum? Some policies cap total benefits at a dollar amount or a number of years.
• What are the benefit triggers? Many policies require assistance with at least 2 of the 6 Activities of Daily Living (bathing, dressing, eating, toileting, transferring, and continence), or qualification based on severe cognitive impairment, such as Alzheimer's disease or another form of dementia.
• Does care need to be provided by a licensed home care agency? Many policies require it.
• How are benefits paid? Most policies reimburse the policyholder after care is provided. Ask about turnaround time.
• Is there a waiver of premium? Some policies stop charging premiums once benefits begin.
• Do I have other coverage? Check life insurance policies, too. Some include long-term care or chronic illness riders that may provide benefits for care at home.

Write down the answers, the name of the person you spoke with, the date and your claim number. You'll want all of it later.

What happens after the claim is opened?

This is where a lot of families get stuck. It's also where BrightStar Care can help.

Once a claim is opened, our team can help with the documentation and ongoing paperwork required by the insurance carrier, including:

• Registered Nurse assessment and Plan of Care
• Required caregiver documentation and care notes
• Ongoing paperwork requested by the carrier
• Follow-up documentation to help keep reimbursement moving

Every BrightStar Care client has a Registered Nurse who supervises their care. That RN visits the home, completes the assessment and builds a personalized Plan of Care, free to the family. Our caregivers document the care they provide on every visit. That's the kind of documentation insurance carriers ask for, so the records are already in place when the carrier needs them.

Why does the home care agency matter for a long-term care claim?

Insurance carriers want to see care provided by a qualified, licensed provider with clear and consistent records. BrightStar Care of Middlesex, Monmouth, Passaic and Western Bergen Counties is a licensed, Joint Commission-accredited home care agency, and our care is supported by Registered Nurse oversight.

Families also choose BrightStar Care because:

• A Registered Nurse supervises every case
• You can reach a live person who knows your loved one's care, 24 hours a day, 7 days a week
• Every caregiver is screened, licensed, insured, bonded and a W2 employee of BrightStar Care
• There are no minimum shifts and no long-term contracts
• We offer a 100 percent Caregiver Compatibility Guarantee
• We're locally and family owned, and families can always reach us, the owners
• We're rated 5 stars on Google and earned Best of Home Care awards for Leader in Experience, Provider of Choice and Employer of Choice in 2025 and 2026

What home care services does BrightStar Care provide?

BrightStar Care of Middlesex, Monmouth, Passaic and Western Bergen Counties has served New Jersey families for 15 years with more than 300 caregivers and nurses. Our services include:

• Personal care, including help with bathing, dressing, grooming, toileting and moving safely around the home
• Companion care, including meals, light housekeeping, errands and medication reminders
• Skilled nursing care from Registered Nurses and Licensed Practical Nurses
• Alzheimer's and dementia care
• Short shifts, overnight care, 24-hour care and live-in care
• Medical staffing, in the home or in a facility

We serve families throughout Middlesex, Monmouth, Passaic and Western Bergen Counties.

Frequently asked questions

Can BrightStar Care tell me whether my policy covers home care?

Your insurance company is the only one who can confirm your coverage and benefits. Once your carrier confirms coverage and the claim is opened, BrightStar Care can help with the documentation and ongoing paperwork the carrier requires.

Does Medicare pay for long-term care at home?

Medicare generally does not pay for ongoing help with daily activities like bathing, dressing and meals. That's one reason a long-term care insurance policy can make such a difference for families.

What if my loved one has dementia but can still do most things on their own?

Many policies treat severe cognitive impairment as a benefit trigger on its own. Ask your insurance company how your policy defines it.

Can care start before benefits begin?

Yes. Many families start care during the elimination period and pay privately until benefits begin. Your insurance company can tell you how that period is counted.

Is there a cost for the Registered Nurse visit?

No. The Registered Nurse visit that builds your loved one's personalized Plan of Care is free to the family.

Have a policy but aren't sure what to do next?

Call us. We can help you understand what information to gather and what will be needed to get care started.