The customer makes that decision. However, if someone is a candidate for Medicaid now or in the near future or is near death, LTCI is not suitable. Alternatively, if someone is about to emigrate, LTCI might not be appropriate if they would have to return to the U.S. to activate coverage. The producer identifies the current cost of a nursing home most likely to satisfy the client. For example, a client without dependents might only want enough coverage to supplement existing income.
Some people prefer Nursing Home Only policies.
However, most people prefer policies which also cover Home Care. Fitting the Need Basic Policy Provisions are an important baseline for suitability. Most policies pay if two ADL deficiencies exist. If not, a '2 ADL' policy might, in practice, not honor a claim until 3 ADLs are lost. Similarly, policies which cover Home Modification can help clients stay at home which can 'save' coverage as well.