How do I get insurance coverage for nursing home care?

By Insurance.com Posted : 01/01/2011

If you're a Medicare beneficiary, Medicare will pay for some nursing home costs under certain conditions if you require skilled nursing or rehabilitation services after a hospital stay of at least three days.

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But Medicare and most health insurance plans don't pay for services that provide help with daily living, such as assistance with getting to the bathroom, bathing and eating.

About half of nursing home patients use their own savings to pay for nursing home costs, according to the U.S. Centers for Medicare and Medicaid Services. If you run through your savings and still remain in a nursing home, you may become eligible for Medicaid, the federal and state insurance program for low-income people. Unlike Medicare, Medicaid covers most nursing home costs.

Long-term care insurance facts

Long-term care insurance pays for daily living care that traditional health insurance plans and Medicare don't cover. In earlier times, these policies were designed to pay primarily for nursing home care.

Today, most policies are comprehensive and cover a variety of services in different settings, such as assisted-living communities, adult day care centers, your own home, special care centers for Alzheimer's patients and nursing homes.

They can also pay for equipment and services that enable you to live at home, such as wheelchair ramps, transportation to doctor appointments and electronic monitoring systems.

Long-term care insurance premiums are based on your age and health status when you apply and the amount of coverage you purchase. Typically, a policy includes a cap on how much it pays out during your lifetime.

For more, see Long-term care: Choices and options.

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