A Table Looking At Paying For Coverage for Home-based Care and Long-term Care
Part 4, Chapter 14: Specialized Situations: Coverage for Long-Term Care Page 12
Continued from Previous Page
Table 18: Coverage for Home-based Care and Long-term Care in a Specialized Facility
| Traditional Health Insurance |
| Home Health Care |
Day Care |
Equipment |
| Provides only limited coverage |
Not generally covered |
Provides coverage if it meets the definition of medical necessity |
| Assisted Living |
Skilled Nursing |
Nursing Home |
| Not generally covered |
Provides only limited coverage |
Not generally covered |
| Medicare |
| Home Health Care |
Day Care |
Equipment |
| Provides only limited coverage |
Not generally covered unless medical services are offered |
Provides coverage if it meets the Medicare definition of medical necessity |
| Assisted Living |
Skilled Nursing |
Nursing Home |
| Not generally covered |
Provides limited coverage under certain conditions |
Not generally covered |
| Medigap Insurance |
| Home Health Care |
Day Care |
Equipment |
| Coverage depends on the policy |
Coverage depends on the policy |
Coverage depends on the policy |
| Assisted Living |
Skilled Nursing |
Nursing Home |
| Not generally covered |
May provide limited coverage as long as the expense is viewed as eligible by Medicare |
Not generally covered |
| Medicaid |
| Home Health Care |
Day Care |
Equipment |
| Coverage depends on state regulations |
Coverage depends on state regulations |
Provides coverage if it meets the Medicaid definition of medical necessity |
| Assisted Living |
Skilled Nursing |
Nursing Home |
| May provide coverage for certain types of care in states with a Medicaid waiver |
Provides limited coverage |
Provides coverage |
| Long-Term Care Insurance |
| Home Health Care |
Day Care |
Equipment |
| Coverage depends on the policy |
Coverage depends on the policy |
Not generally covered |
| Assisted Living |
Skilled Nursing |
Nursing Home |
| Coverage depends on the policy |
Coverage depends on the policy |
Coverage depends on the policy |
| Community Agencies |
| Home Health Care |
Day Care |
Equipment |
| May provide meals and housekeeping |
Not generally covered |
Not generally covered |
| Assisted Living |
Skilled Nursing |
Nursing Home |
| Not generally covered |
Not generally covered |
Not generally covered |
| Veterans' Benefits |
| Home Health Care |
Day Care |
Equipment |
| Provides coverage |
Not generally covered |
Provides coverage |
| Assisted Living |
Skilled Nursing |
Nursing Home |
| Not generally covered |
Not generally covered |
Provides coverage |
| Reverse Mortgage or Home Equity Loan |
| Home Health Care |
Day Care |
Equipment |
| The amount of money available depends on equity |
The amount of money available depends on equity |
The amount of money available depends on equity |
| Assisted Living |
Skilled Nursing |
Nursing Home |
| In some cases, the loan may end if the individual moves to an assisted living facility |
For short-term care; the amount of money available depends on equity |
In some cases, the loan may end if the individual moves to a nursing home |
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