Long-term care insurance

Long-term care insurance

Does Long-Term Care Insurance Cover Medicare Co-Pays?

Certain injuries and medical conditions can lead to drastic changes in lifestyle that require lengthy adjustments and costly assistance on a daily basis. Injuries or illnesses can leave you incapable of bathing and dressing yourself, needing daily care from a nurse or physical therapist, or otherwise incapacitated in such a way that requires extended in-home or facility-based care.

Unfortunately, most standard health insurance coverage does not cover long-term care, and Medicare coverage in these situations is designed for recovery after an injury or sickness, not long-term care that could be permanent. This can leave you and your family burdened with enormous costs in the event you require this type of care. Luckily, this is where long-term care insurance can fill in this gap in your coverage.


How do long-term care insurance and Medicare work together?

Medicare does cover certain aspects of skilled care following a hospital stay. If you have a qualifying hospital stay and seek skilled care within 30 days of discharge, Medicare may cover up to 100 days of care. However anything beyond this amount of care will be your own financial responsibility or that of a long-term care policy. Within those 100 days, costs to you are broken down as follows:

- Days 1-20 — No cost for each benefit period
- Days 21-100 — $152 coinsurance per day of each benefit period

Even within these 100 days, costs can add up quickly and total over $10,000. For this reason, it is important to not rely on Medicare as your only source of potential long-term care financing.


Will long-term care insurance cover Medicare copays?

Generally speaking, since long-term care insurance and Medicare are designed to cover different aspects of your medical needs, they will not pay for each other. There are, however, certain plans called “Medigap” policies that can cover some or all of the coinsurance for days 21-100 of Medicare-eligible skilled care. Not all of these Medigap policies cover skilled-care coinsurance, and not all that do cover these costs cover all of them. However, our team of advisors at Senior Health Solutions, LLC can help you determine if these plans work for you and how more extensive long-term care insurance fits with your needs. To discuss the long-term care options that may exist for you and how they might fit with your Medicare benefits, speak with our team today. Call (636) 244-4415 or contact us online to make an appointment.

Important Information
How to enroll into Medicare
We can help you find a Medicare plan in your area to fit your needs. Once you decide on a plan we can walk you through the Medicare enrollment process.
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How much is the cost?
These are the basic costs for people with Medicare. If you want specific cost information (like whether you've met your deductible, how much you'll pay for an item or service you got, or the status of a claim)
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Do my doctors accept these plans?
Use this helpful link on the Medicare and Medicaid Services (CMS) website to find and choose Physicians and Other Healthcare Professionals enrolled in the Medicare program, as required by the Affordable Care Act (ACA) of 2010.
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What to do if you don't want a part D
If you want to drop your Medicare Prescription Drug Plan (Part D) and you don't want to join a new plan, you can do so during the Open Enrollment Period, between October 15–December 7 each year. The change goes into effect January 1 of the following year.
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Keeping your work benefits
Employer or union health coverage refers to health coverage from your, your spouse's, or other family member's current or former employer or union.
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Medicare - Advantage Plans
A Medicare Advantage Plan is a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits.
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