Long-term care benefits begin after you meet two conditions: a benefit trigger and an elimination period. Benefits trigger when a licensed professional certifies you cannot perform at least 2 of 6 activities of daily living (ADLs) without substantial help, or that you have a severe cognitive impairment such as Alzheimer’s disease. Most policies also include an elimination period — typically 30 to 90 days — during which you cover costs out of pocket before the insurer starts paying. A shorter elimination period reduces your upfront exposure but increases your premium.