It can happen to anyone: a fall, sudden illness, or an accident. Most Americans today have insurance to cover the cost of their medical and hospital care. However, hospital stays are shorter presently than ever before, and we must leave after we are stabilized. To receive the care we need for recuperation and rehabilitation we must either go home and receive assistance or go to an extended care facility.
Medicare does not pay for all care
This is the time most when Medicare beneficiaries begin to realize that Medicare does not pay for all care; in fact Medicare only covers skilled care in an approved facility. Medicare then only pays the first 20 days at 100% and requires hefty co-pays for days 21-100 and nothing after that. For Medicare to cover home care it must be skilled care also and the recipient must be homebound.
For those who have purchased long-term care insurance, they begin the time known as the elimination period. This is the number of days before their benefits kick in: usually 90, 100, 180 or even 365 days.
This can be a time of emotion and critical decisions.
How the care is best provided?
How long may it last?
How will the care be financed?
The first two questions are answered by your physician based on several factors. Regarding costs, the answer most likely will not be Medicare or Major Medical. This will leave you responsible for the payments.
Short-term care insurance can provide an affordable solution for those who:
Would like financing for a short-term care need they feel is very likely to occur,
Those who feel it is too late to plan for LTC, and the premiums are too high,
Those who may not qualify for LTC insurance and
Those who have LTC insurance and want coverage for their elimination period.