Long-Term Care Insurance Policy Review Worksheet
Use this worksheet to clarify what the policy may pay, when benefits start, what settings are covered, and what gap remains.
A long-term care insurance policy should be reviewed before the family builds a care plan around it.
Quick answer
Use this worksheet to clarify what the policy may pay, when benefits start, what settings are covered, and what gap remains.
Policy Snapshot
| Field | Answer | | --- | --- | | Insurance company | | | Policy number | | | Policyholder | | | Claim contact | | | Current benefit amount | | | Daily/monthly benefit | | | Lifetime maximum / pool | | | Inflation protection | | | Elimination period | | | Reimbursement or cash benefit? | | | Premium status | |
Benefit Trigger Review
| Question | Answer | | --- | --- | | How many ADLs must require help? | | | Does cognitive impairment qualify? | | | Who certifies eligibility? | | | Is a plan of care required? | | | How often is reassessment required? | |
Covered Setting Review
| Care setting | Covered? | Conditions / notes | | --- | --- | --- | | Home care | | | | Assisted living | | | | Memory care | | | | Nursing home | | | | Adult day care | | | | Respite care | | | | Family caregiver | | |
Elimination Period Review
| Question | Answer | | --- | --- | | Number of days | | | Calendar days or service days? | | | Must paid care be received? | | | Applies once or per claim? | | | Who pays during waiting period? | |
Uncovered Gap Estimate
| Item | Amount | | --- | --- | | Monthly care cost | | | Monthly policy benefit | | | Monthly family gap | | | Estimated elimination-period cost | | | Estimated benefit duration | |
Kefiw Tip
Ask the insurer for the claim packet before care begins. This helps the family avoid hiring a provider who does not meet the policy's requirements.
Red Flags
- Only brochure is available.
- Policy copy is missing.
- Elimination period is misunderstood.
- Provider requirements are unclear.
- Covered care settings are assumed.
- Benefit is far below local care cost.
- Invoices do not meet claim requirements.
Reusable Product Asset Uses
This worksheet should eventually support:
- Printable PDF.
- Saveable worksheet.
- Calculator result add-on.
- Care Track step.
- Family summary export.
- Email or share version.
- Bring-this-to-a-tour version when relevant.
- Use-before-a-family-meeting version when relevant.
Professional Review
Recommended reviewer: licensed insurance professional, elder law attorney for claim disputes
Sources To Verify
Last reviewed: April 29, 2026.
Kefiw Worksheet Disclaimer
Kefiw provides educational care-planning tools, worksheets, and guides. These materials are designed to help families organize information and prepare better questions. They do not replace medical, legal, financial, tax, insurance, employment, benefits, or professional care advice. Care needs, costs, coverage, provider quality, eligibility, and legal requirements vary by person, plan, provider, state, and situation. For urgent medical concerns or immediate danger, call emergency services.
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Frequently asked questions
› How should families use this worksheet? How-to
Use it before a care decision, appointment, tour, provider interview, or family conversation so the discussion starts with facts instead of memory and stress.
› Is this worksheet professional advice? How-to
No. It organizes information and prepares better questions, but medical, legal, financial, tax, insurance, benefits, employment, and care decisions should be confirmed with qualified professionals.
› Should this be printed or saved? How-to
Both can help. A printed copy is useful during tours or family meetings, while a saved copy helps the family update the plan after care needs, costs, or safety risks change.
› How should I use this guide with a Kefiw tool? How-to
Use the guide as the plan and the linked Kefiw tool as the check. Read the steps first, try the move manually, then use the tool to compare outputs, catch edge cases, and decide whether the result actually fits your task.
› What mistake do tool guides help avoid? Troubleshooting
Tool guides help avoid using a utility mechanically without understanding what you are trying to accomplish. Most word, writing, and text utilities are fast, but speed can hide context mistakes. Know whether you are solving a puzzle, cleaning copy, drafting a line, or checking a rule.