"People think this is a waiting period when you sit around and twiddle your thumbs," Spencer says.
But it works more like a deductible. The elimination period begins when you meet the policy's terms for qualifying for benefits and you start paying for services from a qualified provider.
Typically to qualify for coverage you must be unable to perform two out of six "activities of daily living" on your own. Those are:
- Transferring (for example, from a bed to a wheelchair)
- Maintaining continence
In many cases, you also can qualify if you suffer from a severe cognitive impairment, such as Alzheimer's disease, that puts your health and safety at risk.You can't just sit out the elimination period and rely on neighbors and relatives to help out, and then expect the insurance company to pay for services once the 90 days are up, Spencer says. You have to pay for health care services from providers approved by the insurance company through the elimination period. Then the insurance company will start paying.