Other Insurance
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Will your private health insurance or HMO pay for long-term care services?
Most forms of health insurance, such as the private health insurance or HMO you may have on your own or through your employer, follow the same general rules as Medicare with regard to paying for long-term care services. If they do cover long-term care services, it is typically only for skilled, short-term, medically necessary care.
Like Medicare, the skilled nursing home stay must follow a recent hospitalization for the same or related condition and is limited to 100 days. Coverage of home care is also limited to medically necessary skilled care. Though most people who need long-term care services need custodial or personal care, most forms of private insurance do not cover custodial or personal care services at all.
Your plan may help you pay for some of the copayments or deductibles that Medicare imposes. For example, your plan may help cover the $137.50 per day for Medicare covered nursing home care for days 21 through 100.
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Will your Medicare Supplemental Policy pay for long-term care services?
Medicare supplemental insurance policies, also called “Medigap insurance,” are designed to fill in some of the gaps in Medicare coverage. Specifically, these policies help to cover Medicare copayments and deductibles. Medigap insurance enhances your hospital and doctor coverage, but does not extend to long-term care coverage. For the small portion of nursing home stays that qualify for Medicare coverage, a Medigap insurance policy may cover the daily Medicare copayment of $137.50 perday for days 21 through 100. Medigap insurance is not intended to meet long-term care needs and provides no coverage for the vast majority of long-term care expenses.
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Will my disability insurance pay for long-term care services?
Disability insurance is intended to replace some of the income of a working person who can no longer work because of a disability. Disability benefits do not cover medical care or long-term care services. Most disability insurance policies do not provide benefits once you are over age 65—when you are most likely to need long-term care services.
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