Plan of care is the written outline created by a licensed health professional that describes the specific services, frequency, and goals of care for a patient who needs ongoing assistance. In long-term care and chronic-illness settings, the plan of care details which activities of daily living require help, what skilled services are needed, and how progress will be monitored. Insurers rely on an approved plan of care to determine benefit eligibility and to coordinate covered services, especially when policies reimburse home health, assisted living, or nursing facility care.

Advisors encounter a plan of care when clients file long-term care, chronic-illness, or disability claims. Claims departments require a physician, nurse, or care manager to complete or approve the plan, confirming that the insured meets contract triggers. Families use the plan of care to organize caregiving tasks, hire agencies, and track improvements or decline. Advisors often explain that benefits follow the documented plan, so accuracy and updates are essential. Understanding plans of care helps advisors manage expectations about which services are reimbursable and how care plans interact with policy provisions over time.