Minimum Standards for LTC Policies in New York

New York State has established minimum standards for insurance policies covering long term care services.
The Department has established four different classifications for these policies:

  • Long Term Care Insurance
  • Nursing Home and Home Care Insurance
  • Nursing Home Insurance Only
  • Home Care Insurance Only

Long Term Care Insurance policies provide the broadest coverage of long term care services. The Department requires that these policies cover, for at least 24 consecutive months, the following benefits:

  • Coverage of all levels of care in a nursing home of at least: $100 per day for policies sold in the New York City Metropolitan area (the counties of Bronx, Kings, Nassau, New York, Queens, Richmond, Suffolk, Rockland and Westchester); and $70 per day for all other parts of New York State; and
  • Coverage of home care of at least 50% of the daily indemnity amount provided for care in a nursing home.

Nursing Home and Home Care Insurance combines the benefits of Nursing Home Insurance Only and Home Care Insurance Only. This policy is for those persons who want some coverage for nursing home and home care services but who cannot afford Long Term Care Insurance.

The Department requires that these policies cover, for at least a period of 12 consecutive months, the following benefits:

  • Coverage of custodial care services of at least $50 a day while confined in a nursing home; and
  • Coverage of custodial care services of at least $25 per day in a private home.

Nursing Home Insurance Only is for those persons who either have no desire or intention to receive long term care services in their home or have the financial resources to self-pay for home care services, but desire financial protection against the greater cost of nursing home care.

  • Nursing Home Insurance Only must provide at least twelve consecutive months of coverage of custodial care services of at least $50 a day while confined in a nursing home.

IF THERE IS ANY CHANCE THAT YOU MAY REQUIRE INSURANCE COVERAGE FOR HOME HEALTH CARE SERVICES IN THE FUTURE, A NURSING HOME INSURANCE ONLY POLICY MAY NOT BE THE BEST TYPE OF LONG TERM CARE COVERAGE FOR YOU.

Home Care Insurance Only is a very limited policy. This type of policy should only be considered by those persons who either have no desire or intention of entering a nursing home, and would be able to obtain long term care services in their home or have already purchased a nursing home policy and wish to add a home care benefit.
Home Care Insurance Only must provide at least twelve consecutive months of coverage of custodial care services of at least $25 per day in a private home.

IF THERE IS ANY CHANCE THAT YOU MAY REQUIRE NURSING HOME SERVICES IN THE FUTURE, A HOME CARE INSURANCE ONLY POLICY IS MOST LIKELY NOT THE BEST TYPE OF LONG TERM CARE COVERAGE FOR YOU.