Medicare, Medicaid, Medicare Advantage, Medigap, PPO, HMO, ACO-- the health care market is a confusing alphabet soup of names and initials. Few people understand what type of plan they have. Even fewer understand what their plan covers. One assumption many make is that once an individual becomes Medicare eligible, everything is covered, including long-term care.
That is a dangerous supposition. Medicare, like most insurance, covers health care, but not personal care. Because long-term care focuses on personal needs, most insurance, including Medicare, provides little or limited coverage.
What does Medicare cover?
Medicare is a federal program that pays for the health care needs for seniors. It is meant to cover acute care, such as doctor visits, hospital stays, tests, and medication. While acute care may involve chronic conditions, such as diabetes or heart problems, it does not include coverage for day-to-day living. In other words, Medicare is meant to treat you when you are sick; it is not meant to help with the personal difficulties of aging.
Long-term care is not acute care. It is the type of care individuals need when they can no longer do all of the everyday things they used to do, like buy groceries, go to a doctor's appointment, and take a bath. Sometimes it involves in-home care; other times it may take the form of residential care. Whether it is at home or in a residence, long-term care can be shockingly expensive.
What insurance covers long-term care?
It is rare for any general insurance to provide much in the way of long-term benefits.
Private insurance sometimes covers long-term care. When it does, it usually provides very limited benefits.
Medicaid provides long-term care, but it restricts its benefits to low-income individuals who meet very strict income guidelines.
Disability insurance only replaces lost income.
Long-term care policies are the only insurance policies that provide comprehensive long-term care coverage. These policies often pay for both home health care and facility care.
The benefits of long-term care policies
Long-term care insurance safeguards you against the shock and expense of needing services you never expected. This type of coverage can save you thousands of dollars. It ensures not only that you get the services you need, but also that your hard earned retirement funds do not dribble away in a matter of months instead of the years for which they were intended.
If you already have a long-term care policy, check its coverage. Make sure that you know what type of care is covered and how much your out-of-pocket costs are. If you do not have a policy, discuss with your agent what type of long-term policy best meets your needs. Before you decide that you absolutely do not need this type of coverage, do some research. Think about the quality of life you want as you get older. Preparing for long-term care today is cheaper than getting the bill for it tomorrow.
The skilled St. Louis long term care insurance professionals at Senior Health Solutions help you assess your current insurance. We help individuals in St. Louis and throughout the Tri-State area decide what kind of coverage they need after they retire. Our expertise helps you protect yourself against life's unexpected surprises. Contact us online today or call us at (636) 244-4415.