Everyone faces medical problems from time to time, and most can be resolved through a simple visit with a doctor. In more complicated situations, however, hospital care or care in a skilled nursing facility may be required. Treatment in one of these facilities is typically short-term in nature, lasting a few weeks to a few months at most.
When treating a chronic condition or a condition that is severely debilitating, long-term care may be required. This type of care is usually provided for years or for the remainder of a person’s life. Depending on the reason for requiring long-term care, medical services may be administered in a hospital, skilled nursing facility or in your home.
Dealing With the Costs Associated With Using Medicare
Out-of-pocket medical costs often cause Medicare recipients to seek out solutions in the form of Medicare Supplement insurance coverage. Plans that offer this coverage are usually known as Medigap policies, and they are designed to offer coverage for costs associated with using Original Medicare, including deductibles and co-pay amounts.
Does Medigap Cover Long-Term Care?
If you already carry Medicare benefits, you likely know that the program does not provide long-term care coverage. Medicare does provide coverage for short term hospital care or care in a skilled nursing facility, but if you need care beyond a 90-day period, you’re likely going to need to pay out of your own pocket.
Unfortunately, Medigap does not cover long-term care either. Since Medicare Supplement insurance policies are meant to cover certain costs associated with the use of Medicare benefits, these types of policies do not provide actual healthcare benefits directly.
Medigap may, however, cover certain costs associated with short-term care. Because short-term care typically requires Medicare recipients to meet a deductible and may involve co-pays, a Medigap policy could potentially provide coverage toward these costs. This will depend on your plan and the type of coverage you have selected.
Do Medigap Plans Cover In-Home Care?
Whether short- or long-term, in-home care may be an alternative to hospital care or care in a skilled nursing facility. Some at-home medical care services provide full medical support, but others offer simple services that include light housework, transportation and bathing.
Medigap policies do not generally apply toward these types of services since these services are also not covered by Medicare. If an in-home care service is covered by your Medicare benefits, it may be possible to apply Medigap coverage toward expenses like co-pay amounts, but this will be entirely dependent on your plan and the services provided.
Medicare Advantage, Medigap and Long-Term Care
Another possible way to lower costs for long-term care is by enrolling in a Medicare Advantage plan. These plans offer the same Part A and Part B benefits of Original Medicare, but they often come with extra coverage that may not be included in Original Medicare.
These plans, however, will not work alongside Medigap coverage since you are not able to carry both. If you have a Medicare Advantage plan and you choose to drop this coverage in favor of reverting to Original Medicare, you may be able to buy a Medigap plan at that time. If you are beyond your 6-month Initial Medigap Enrollment Period, you may be subject to medical underwriting.