The below chart shows the most common types of insurance and the very limited long-term care coverage they provide.
Public | Private | ||
---|---|---|---|
Long-term care Service | Medicare | Medigap Insurance | Private Health Insurance |
Overview | Limited coverage for nursing home care following a hospital stay and home health if you require a nurse or other skilled provider | Insurance purchased to cover Medicare cost sharing | Varies, but generally only covers services for a short time following a hospital stay, surgery or while recovering from an injury |
Nursing home care | Pays in full for days 1–20 if you are in a Skilled Nursing Facility following a recent 3-day hospital stayIf your need for skilled care continues, may pay for the difference between the total daily cost and your copayment of $137.50 per day for days 21-100. After day 100 does not pay | May cover the $137.50 per day copayment if your nursing home stay meets all other Medicare requirements | Varies, but limited |
Assisted living facility (and similar facility options) | Does not pay | Does not pay | Does not pay |
Continuing Care retirement community | Does not pay | Does not pay | Does not pay |
Adult day services | Not covered | Not covered | Not covered |
Home health and personal care | Limited to reasonable, necessary part-time or intermittent skilled nursing care and home health aide services, some therapies if a doctor orders them, and a Medicare-certified home health agency provides them.Does not pay for on-going personal care or only help with Activities of Daily Living (also called "custodial care") | Not covered under current policies.Some policies sold prior to 2009 offered an at-home recovery benefit that pays up to $1,600 per year for short-term at-home assistance with activities of daily living (bathing, dressing, personal hygiene, etc.) for those recovering from an illness, injury, or surgery | Varies, but limited |