StartupHomeCare Blog

Does Health Insurance Pay For Long Term Care Services?

by Editor

Posted in Senior Care | 1 Comment

Having medical insurance is no guarantee you’ll be able to use it for mom and dad’s long-term care. According to an analysis of health insurance plans by website HealthPocket, 99 percent of policies exclude coverage for long-term care.

That’s likely because long-term services often fall under the category of custodial care. In other words, many seniors need help with daily living activities, but they don’t have specific medical needs that require skilled care.

While medical insurance may not pay for ongoing long-term care, you may be able to get some short-term help for your parents as you determine how best to pay for their ongoing needs.

Health insurance, including Medicare, may pay for the following services:
Short term nursing home placement: Health plans may pay for a limited amount of nursing home care – 100 days under Medicare – for those who have been recently hospitalized. Coverage may only be available if skilled care, such as rehabilitation, is required.
Medically necessary in-home care: Health insurance plans may also pay for in-home care that is medically required, such as wound care or the administration of medication. In some cases, a hospitalization may be required for an individual to become eligible for these in-home benefits.
Hospice: Medicare, Medicaid and most private health insurance plans will pay for hospice care. Some private plans may pay for home hospice only and exclude coverage of services provided in a residential hospice facility.

Although health insurance isn’t a solution to long-term care needs, it may provide families time to investigate other payment options, particularly in cases in which a loved one is unexpectedly hospitalized with an injury or illness.

 

One response to “Does Health Insurance Pay For Long Term Care Services?

  1. My grandma recently broke her hip and we’ve been wondering if it might be a good idea to hire her some home care assistance to help her with the small things around her home. So thanks for telling us that we should be sure to hire someone full time if our loved one needs assistance anytime they are walking. I’ll be sure to start looking for a full-time home health care assistance since my grandma won’t be able to walk for at least a few weeks without any sort of help.

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