Employer-sponsored health plans and other forms of health insurance
Most forms of health insurance (e.g., PPO, indemnity, HMO) typically cover long
term care only if it is considered medically necessary "skilled care" that is
rehabilitative. Insurance carriers’ policies generally mirror Medicare rules.
Health insurance generally covers long term care up to 100 days after a recent
hospital stay, doctor-prescribed home care as part of a rehabilitative program,
and hospice in the case of terminal illness. Custodial or personal care is never covered.
Insurance partially covers some skilled nursing facility care, up to 100 days after
a hospital stay. This does provide some coverage if you experience a major medical
For employer-sponsored health plans, you must be working for the company in order to receive benefits. Coverage may not
be available after you retire.
Insurance will cover some skilled nursing care, therapy, and home health aide services
that are ordered by a physician.
You are responsible for any copays, coinsurance or deductibles as specified in the
evidence of coverage. Care provided in assisted living and continuing care facilities is not covered.
Your company may cover some or most of the cost of premiums for this coverage.
Health insurance does not cover personal or custodial care provided at home or in