Elimination Period

An elimination period is the stretch of time that must pass after a covered disability or care need begins before the policy starts earning benefits for the insured. It is a deductible measured in time rather than dollars, and because benefits are paid on amounts that have already accrued, the first money usually arrives later than the period alone suggests.

Last reviewed by Steven Fox, CFP®, EA on August 17, 2026

Quick Summary

It is a deductible denominated in time. Nothing accrues during it, and on the ordinary design nothing is paid for it afterwards either.
In long-term care insurance the same clock goes by three names. The NAIC's mandated buyer worksheet writes it as "elimination period", "waiting period" or "cash deductible", treating them as alternatives for one concept.
Where the NAIC model regulation has been adopted it is capped on individual disability income coverage: no more than 90, 180 or 365 days depending on how long the benefit itself can run.
Only one elimination period may be required where a policy provides both total and partial disability benefits. But a residual benefit's qualification period is a separate clock and may be longer.
Plan for the period plus a payment interval. Benefits are paid on accrued amounts at intervals no less frequent than monthly, so a 90-day period usually means about four months without benefit income.

Definition

An elimination period is a contractual waiting period, measured in days, that begins when a covered disability or care need begins and during which no benefit accrues. It appears in disability income insurance and in long-term care insurance, and in both it functions the way a dollar deductible functions on a property policy: it is the layer of loss the insured absorbs, and lengthening it lowers the premium. The regulatory material treats it as a term of art without defining it, which is why the same clock is written under different names. NAIC's Long-Term Care Insurance Model Regulation, which states adopt with variations, prescribes a personal worksheet that a buyer completes before purchase, and that worksheet asks "What [elimination period][waiting period] [cash deductible] are you considering?" and then "How do you plan to pay for your care during the [elimination period] [waiting period] [deductible period]?". The bracketed alternatives are the regulator's own acknowledgment that the market uses three names for one thing.

Advanced Explanation

How long the period may be is regulated on individual disability income coverage, and the ceiling scales with the benefit. The NAIC's Model Regulation to Implement the Accident and Sickness Insurance Minimum Standards Model Act applies to individual accident and sickness policies and to group supplemental health coverage, and its section 7G(2) requires disability income protection coverage to contain "an elimination period no greater than" 90 days where the benefit runs a year or less, 180 days where it runs more than one year but not more than two, and 365 days in all other cases. The logic is proportionality: a short benefit cannot be swallowed by a long wait. Note the scope, because it is easy to overextend. That regulation does not govern long-term care policies, which it excludes expressly, and it does not govern a group long-term disability certificate. Its ceilings describe individual disability income coverage.

Two clocks can run in the same policy, and confusing them is the commonest reading error here. Section 7G(4) of the same regulation provides that "where a policy provides total disability benefits and partial disability benefits, only one elimination period may be required", which prevents an insurer charging a claimant a second wait for stepping down to partial benefits. But section 5L permits a policy offering residual disability benefits to require a qualification period, during which the insured must be continuously totally disabled before residual benefits are payable, and states plainly that this "qualification period for residual benefits may be longer than the elimination period for total disability". So one elimination period, and possibly a longer separate gate before a residual benefit begins.

The part that decides household planning is not the length of the period but when money actually lands, and it is a mechanic almost no summary mentions. The NAIC's Uniform Individual Accident and Sickness Policy Provision Law, another model states adopt, requires an individual policy to include a "Time of Payment of Claims" provision under which, subject to due written proof of loss, "all accrued indemnities for loss for which this policy provides periodic payment will be paid" at an interval that "must not be less frequently than monthly". The operative word is accrued. Benefits are paid for periods of disability that have already happened, so the first payment cannot arrive when the elimination period ends. It arrives after the first benefit interval has itself elapsed and proof of loss has been furnished.

One further distinction is worth keeping straight, because both use ninety days and they are not the same thing. A tax-qualified long-term care contract pays when a licensed health care practitioner certifies that the insured cannot perform at least two activities of daily living "for a period of at least 90 days", or requires substantial supervision because of severe cognitive impairment. That ninety days is a prognosis about how long the impairment is expected to last, and the NAIC's model regulation records the Internal Revenue Service's position that the requirement "does not establish a waiting period before which benefits may be paid or before which services may constitute qualified long-term care services". The policy's elimination period is the waiting period, and it is a separate provision that the policy sets. A contract can have a 90-day benefit trigger and a 0-day elimination period, or a 90-day trigger and a 180-day elimination period.

How to Remember

It is a deductible you pay in days rather than dollars, and like a deductible it buys down the premium. Then add one payment interval, because the insurer pays for time that has already passed.

Used in a Sentence

“Marisol's policy carries a 180-day elimination period, so she needs six months of income from somewhere before the first benefit is even calculated.”

How It Works

The period begins when the covered disability or care need begins, subject to the policy's own rules about whether separate absences can be added together. Nothing accrues during it. Once it is satisfied, the benefit begins accruing, and the insurer pays what has accrued at the policy's stated interval on receipt of proof of loss. Lengthening the period lowers the premium because it removes the shortest and commonest claims from the insurer's exposure, which is also why the reduction in premium is largest at the short end of the range and flattens out at the long end.

A hypothetical example of the arithmetic households actually need. Take a policy with a 90-day elimination period and monthly benefit payments. Income stops on day 1. The elimination period runs through day 90, and nothing has accrued. The first month of benefit then accrues over days 91 to 120. Only after day 120, and after proof of loss has been furnished, is that first month payable. So the gap to plan for is roughly four months of living expenses, not three. The same arithmetic on a 180-day elimination period gives about seven months rather than six.

That is the number to size an emergency fund or a short-term disability benefit against. It is also the number to have in mind when comparing quotes, because the premium saving from lengthening the period is real and so is the cash it requires. A household with twelve months of accessible savings is buying a genuinely cheaper policy by choosing a long period. A household with two months of savings is buying a policy that will not pay in time to matter.

Pros and Cons

Pros

It is the most direct lever on the premium, and unlike cutting the benefit amount it leaves the catastrophic coverage intact.
Choosing a longer period is a coherent decision for a household that already holds several months of accessible savings.
Where the NAIC model regulation has been adopted, it is capped on individual disability income coverage, so the wait cannot be scaled up without limit against a short benefit.
Where a policy pays both total and partial benefits, only one elimination period may be required, so stepping down to partial benefits does not restart the wait.

Cons

Nothing is paid for the period itself on the ordinary design, so the money is genuinely gone rather than deferred.
The first payment arrives an interval later than the period ends, which is the part most buyers do not price.
A residual benefit's qualification period is a separate clock and may be longer than the elimination period for total disability.
The same clock is called three things in long-term care insurance, which makes comparing two policies harder than it should be.
It is easily confused with a long-term care policy's 90-day benefit trigger, which is a prognosis rather than a wait.

People Also Asked

Answers to the most frequently asked questions.

Is an elimination period the same as a waiting period?

In long-term care insurance they are used interchangeably, and the NAIC's model buyer worksheet writes the same field three ways, as "elimination period", "waiting period" or "cash deductible". In disability insurance "elimination period" is the standard term. Because a policy chooses its own wording, compare the provision rather than the label when comparing two contracts.

Is the elimination period the same as a long-term care policy's 90-day requirement?

No, and conflating them produces the wrong expectation about when benefits start. A tax-qualified long-term care contract's trigger requires certification that the insured cannot perform at least two activities of daily living for a period expected to last at least 90 days, which is a prognosis. The NAIC's model regulation records the Internal Revenue Service's position that this requirement does not establish a waiting period before which benefits may be paid. The elimination period is a separate provision the policy sets, and it can be shorter, longer or zero.

How long can an elimination period be?

On individual disability income protection coverage the NAIC model regulation caps it at 90 days where the benefit runs a year or less, 180 days where it runs more than one year but not more than two, and 365 days in all other cases. That regulation governs individual accident and sickness policies rather than long-term care contracts or group long-term disability certificates, and states adopt model regulations with variations, so the operative rule is the state's own.

Do I get paid for the elimination period once benefits start?

On the ordinary design, no. The period is the layer of loss the insured absorbs, and the benefit begins accruing only after it is satisfied. Whether any benefit is payable for the period itself is a matter of the policy's own language, so it is worth reading rather than assuming in either direction.

Can a policy make me satisfy two elimination periods?

Not for the same disability where the policy pays both total and partial benefits: the NAIC model regulation provides that only one elimination period may be required in that case. A residual benefit is different. The same regulation permits a qualification period of continuous total disability before residual benefits become payable, and expressly allows it to be longer than the elimination period for total disability.

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