Medigap and Long Term Care insurance serve different purposes and cover different types of expenses, so whether you should purchase Medigap or Long Term Care insurance (or both) depends on your specific needs and financial situation. Keep reading to learn more about both insurance options below and along the way we hope to clear up some misconceptions about both insurance products.
What is Medigap?
Medigap insurance, also known as Medicare Supplement Insurance, is designed to help cover out-of-pocket costs that are not covered by Original Medicare (Part A and Part B), such as deductibles, copayments, and coinsurance. Medigap policies do not cover long-term care expenses, such as those associated with nursing home care, assisted living, or in-home care.
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What is Long Term Care insurance?
Long Term Care insurance, on the other hand, covers expenses related to extended care, such as those associated with nursing home care, assisted living, or in-home care. Long Term Care insurance (LTC) usually covers custodial care for those who need help bathing and cleaning. These types of expenses can deplete your savings and assets, but LTC can help protect them. Long Term Care will NOT help pay for medical bills that Medicare passes on in the form of out-of-pocket costs.
Does Medicare provide Long Term Care Coverage?
Original Medicare (Part A and Part B) does not provide coverage for most Long Term Care services, such as those associated with nursing home care, assisted living, or in-home care. However, Medicare does provide limited coverage for skilled nursing facility care and some home health services under certain circumstances.
Medicare Part A may cover a portion of up to 100 days of skilled nursing facility care following a hospitalization of at least three days, but only if certain criteria are met, such as requiring daily skilled care and being admitted to a Medicare-certified skilled nursing facility within 30 days of a hospital stay. After you exhaust the 100-day benefit period, you will be responsible for paying the cost of care. (Note: Medigap plans can help pay for some or all of the 100-day skill nursing care that Medicare typically passes on to the patient.)
Medicare Part B may cover certain home health services, such as skilled nursing care, physical therapy, and speech-language pathology services, if they are medically necessary and prescribed by a doctor. However, the insurance company limits the coverage, and you may still have to pay for some of the costs, such as copayments and coinsurance. (Note: Medigap plans can cover some or all of the Medicare Part B costs not covered by Medicare).
Medicare also has some coverage for end-of-life hospice care but, in general, Medicare does not cover the custodial care that many people are looking for in an LTC policy.
Should I buy Medigap or Long Term Care insurance?
Whether to purchase Medigap or long-term care insurance depends on your individual needs and financial situation and, frankly, your timing. Once again the two products are completely separate so you should evaluate them separately.
- Should I buy Medigap?
If you are concerned about out-of-pocket costs associated with Medicare, such as copayments and deductibles, you may want to consider purchasing a Medigap policy. Medigap policy is a good way to address these costs that Medicare passes on to you. To see the pricing of Medigap plans click here. To speak to senior65.com about Medigap call us at 800-930-7956.
- Should I buy LTC?
If you are concerned about the costs of long-term care expenses and want to protect your savings and assets, you may want to consider purchasing long-term care insurance. Who isn’t concerned about these costs? The real question is WHEN are you concerned about these costs? If you are 80 years old and have many pre-existing conditions, you are probably too late for LTC. Long Term Insurance is most affordable when you are younger and healthy. Each year you wait, the cost of LTC usually gets more expensive. You really want to contact an agent who is licensed to sell LTC to review your specific situation. You can contact the American Association of Long Term Care Insurance for help finding a local LTC agent.
NOTE: Licensed Medicoverage Inc agents available at Senior65.com do not sell LTC.
Who would be a good candidate for BOTH Medigap and long-term insurance?
Good candidates for both Medigap and long-term care insurance include individuals who are at risk of high medical expenses and worry about future ongoing homecare costs but know that they will not have the resources to pay for these fees without insurance. The ideal person is one who plans ahead and purchases LTC early and Medigap when they were first enrolled for Medicare Part B.
The bottom line is that we recommend that you look at both insurance products separately as part of your total health and wealth protection plan. One product will not fill in for the other. For help with Medigap questions, pricing, or enrollment, call Senior65.com at 800-930-7956.