A policy may include a straight monetary deduction before it begins to pay. In this case you would have to pay a home care worker a certain amount out of pocket before receiving any payment.
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It's true that there are government programs that provide long term care coverage but these aren't that reliable compared to your other options. Their limitations hinder people from receiving proper care they need, which can help them recuperate from their injuries, disabilities and conditions. And because of this, people resort to purchasing private insurance. You can read in http://www.ltcoptions.com/ that there are long term care insurance companies that offer affordable coverage. It's not as expensive as you think as long as you explore your options first. Also, this is the cheapest way to pay for caregiver, nursing home and other ltc services since the cost of long term care increases every year.