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
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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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