What actually determines how much a long-term care policy pays: the type of cover, fixed-sum versus indemnity, living at home or in an institution, age at joining, index linking and duration of payment — and where to check the figure that applies to you.
The honest answer: there is no single figure, and there is a good reason for that
Search online for how much long-term care insurance pays and you will find numbers. The problem is that almost every one of them comes from a particular policy belonging to a particular person, and often from years ago. It tells you nothing about what you are owed.
Long-term care insurance is not a government benefit with a uniform table. It is a contract. The amount is set in the document signed when the policy was taken out, and it differs between companies, between products, between periods and even between two people who joined the same product a few years apart.
What you can do — and this is what this page is for — is understand exactly which factors determine the amount, and where to find the figure relevant to you. Once you know these five parameters, you can look at your own policy and understand what it says.
The five factors that determine the benefit
Every long-term care policy rests on the same axes, even when the values differ. These are the things to look for in the policy document, or to ask the insurer about.
- Type of cover — a private policy or group cover through a health fund. The terms differ substantially
- Fixed sum or indemnity — a predetermined amount, versus reimbursement tied to proven expenditure
- Place of residence — in many policies the benefit at home differs from the benefit in an institution
- Age and period of joining — the amount set at the time of joining and the product terms of that period
- Duration of payment — a limited period (a number of years) versus payment for as long as the condition persists
- Index linking — whether the amount is linked to the index or fixed, and what that means after twenty years
Fixed sum versus indemnity: the distinction that changes the most money
This is the most important distinction, and the one that surprises families more than any other. Under a fixed-sum policy, the policy sets a monthly amount. If the care condition is met and the claim is approved, that amount is paid, regardless of what you actually spent.
Under an indemnity policy, payment is tied to proven expenditure. That is, even if the policy states a particular amount, only what you actually spent may be paid, and only against supporting documents — invoices from an institution, a carer's employment contract, payslips.
The practical consequence is critical: a family with an indemnity policy that did not keep receipts may find at a late stage that it cannot prove the expenditure. This is therefore one of the first things to clarify — before filing, not after approval.
Home versus institution: why it changes the amount
Many policies distinguish between living at home and staying in a nursing institution, and set different benefit rates for each. Sometimes the institutional benefit is higher, sometimes the opposite, and sometimes one is a fixed sum while the other is an indemnity.
This means that moving the insured person from home to an institution — or back — may change the payment. Many families are unaware that the change must be reported and that additional documents are sometimes required.
If the insured person is in an institution and the cover is indemnity-based, keep the invoices and confirmations from the facility on a continuing basis. Collecting them retroactively a year later is far harder.
What about the National Insurance care benefit?
It is important not to confuse the two. The long-term care benefit from National Insurance is not a policy payout — it is a statutory right, provided mainly as a basket of services (care hours, a day centre, incontinence supplies) rather than as a free cash transfer.
A payout from private or group long-term care insurance, by contrast, is generally paid as money. These are two entirely separate tracks, examined by different bodies under different rules.
The practical implication: receiving the care benefit does not remove the need to check the policy, and vice versa. In many cases a family is entitled to both, and each is examined separately.
Where to check your actual amount
Once you understand what affects the figure, the remaining task is to find it. There are three main places, and it is worth going through them in order.
The first and binding one is the policy wording itself. It states the benefit amount, the linkage mechanism, the distinction between home and institution, and the duration of payment. If you do not hold the document, you may request it from the insurer — that is your right.
The second is the annual report or insurance certificate, which sometimes shows the updated amount. The third is a direct written request to the insurance company or health fund for a breakdown of the cover. In parallel, if you do not know which policies exist at all, start with Har HaBituach.
- The full policy wording — the binding document
- An annual report or insurance certificate from the company
- A written request to the insurer for a breakdown of the cover
- Har HaBituach, the Capital Market Authority registry — for cover you did not know about
- The personal area on your health fund's or insurer's website
A common mistake: giving up because the figure sounds low
Families sometimes hear a number, decide it is not worth the trouble, and drop the matter. That is a mistake for two reasons.
The first is that the benefit is generally paid monthly, and often for an extended period. An amount that looks modest when you look at it once accumulates significantly over years.
The second is that in most cases the family never checked whether more than one policy exists. An old private policy, cover through an employer, or a spouse's cover may all exist in parallel without being known. Before giving up, it is worth at least knowing what you have.
Frequently asked questions
How much does long-term care insurance pay per month?
There is no uniform amount. The benefit is set in the policy wording and varies by type of cover, age and period of joining, place of residence and the linkage mechanism. Check the exact figure in the policy document or with the insurer.
What is the difference between a fixed-sum policy and an indemnity policy?
A fixed-sum policy pays a set amount stated in the policy, regardless of actual expenditure. An indemnity policy ties payment to proven expenditure and sometimes requires invoices. This is the distinction that affects the amount received more than any other.
Is more paid when the insured person is in an institution?
It depends on the policy. Many policies set different benefit rates for living at home and for staying in an institution. Moving between them may change the payment and sometimes requires notification and further documents.
Is the long-term care benefit linked to the index?
In some policies yes and in others no. This is material, because an unlinked amount loses value over the years. Check the linkage mechanism in the policy wording.
Can I receive both the National Insurance benefit and a policy payout?
These are separate tracks examined under different rules, so there is no basic obstacle to checking and claiming under both. The care benefit is provided mainly as services, while a policy payout is generally paid as money.
How long is the benefit paid for?
The duration is set in the policy. In some products it is a limited period, and in others payment continues for as long as the care condition persists. This is one of the most material differences between policies.
Official sources for further checking
This is general information and does not replace personal medical, legal or insurance advice. Eligibility is determined by the documents and rules that apply to each case.
