Mom's LTC insurance refuses to pay anything for ongoing stay in memory care because the business isn't licensed as a nursing home. Advice?

We have opened a file with the state insurance commission. Hopefully they will be able to resolve our issue without having to hire a lawyer. Thanks for all your input. I'll keep you updated

LPainte, I haven't had to deal with a LTC insurance company, but I heard about similar difficulties with them from others in my Alzheimer's support group. Having an attorney write the insurance company a letter will probably work, as might a call or letter to your state's insurance regulator. Another idea that might work is to find a nursing home that has a memory care wing (many or most of them do) and see if it will accept your mom. But before you move her there, you can let the LTC insurance company know what you're going to do and how much it's going to cost (probably at least 50% more than the her current assisted living memory care facility -- I suspect that will cause the insurance company to reconsider its prior refusal to pay. Best wishes.

I wish you good luck. LTC facilities are not regulated in the way nursing homes are; they often don't accept/aren't qualified for governmental assistance also.
I try to warn people about LTC all the time. They will weasel out, often enough, for ANYTHING and everything, including some writing in the fine print that the facility must have an onsite RN 24/7, which of course none ever DO have.
As with getting reverse mortgage, these things work for some people, but for others they actually put a stop to getting help and getting care.
I sure do wish you good luck on this one and hope you will update us.

Try contacting the state agency that regulates insurance companies and see if they have any remedies for this situation.

Get a lawyer.