Long term care insurance typically kicks in when an individual meets certain eligibility criteria, such as being unable to perform a certain number of activities of daily living (ADLs) independently or requiring substantial assistance due to cognitive impairment. The specific triggers for coverage may vary depending on the policy and insurance provider. Some common ADLs used to determine eligibility include bathing, dressing, eating, toileting, transferring, and continence. Once an individual meets the eligibility criteria, there may be a waiting period, also known as an elimination period, before the insurance coverage begins. This waiting period is typically a specified number of days, such as 30, 60, or 90 days, during which the individual is responsible for covering their own long term care expenses. After the waiting period, the insurance coverage becomes active and the policyholder can start receiving benefits to cover the costs of long term care services, such as nursing home care, assisted living, or in-home care. It's important to review the terms and conditions of the specific long term care insurance policy to understand the exact triggers for coverage and any waiting periods that may apply. Please note that this information is based on general knowledge about long term care insurance and may vary depending on the specific policy and insurance provider. It's always recommended to consult with an insurance specialist or review the policy documents for accurate and up-to-date information.