Does My Private Health Insurance or Health Maintenance Organization (HMO) Pay for Long-Term Care?
Most forms of health insurance (such as the private health insurance or Health Maintenance Organization (HMO) you may have on your own or through your employer) follow the same general rules as Medicare. If they do cover long-term care, it is typically only for skilled, short-term, medically necessary care. Like Medicare, the skilled nursing home stay must follow a recent hospitalization for the same or related condition. Coverage in a Skilled Nursing Facility is limited to 100 days. Home care is also limited to medically necessary, skilled care. Custodial or personal care is never covered. However, most people who need long-term care need custodial or personal care. If you receive your health care from an HMO, the plan may help you pay for some of the co-pays or deductibles that Medicare would otherwise impose (for example, the $128/per day for nursing home care for days 21 through 100), but they otherwise do not vary from Medicare’s rules for what type of care is covered or for how l
