Which Medigap Policies Provide Coverage for Long-Term Care?

About

Medicare 101

Current Clients

Which Medigap Policies Provide Coverage for Long-Term Care?

various cartoon scenarios showing long term care stock photo

By Daniel Petkevich

Sep 16, 2022

Everything You Need to Know About Long-Term Care

As we age, daily chores we might take for granted — like cooking and bathing — can become challenging.

Speak with a Medicare Advocate

Talk to one of our Licensed Medicare Agents today to find the right plans for you.

If you develop age-related health issues, you might need long-term care.

Medicare and Medigap plans may only cover certain long-term care services. However, you can protect yourself by investing in a long-term care insurance plan.

Let's dive deeper into long-term care and discuss how you can get coverage.

What Is Long-Term Care?

Long-term care

includes any health-related services that are needed for an extended period. It covers everything from long-term medical care to financial support to housing arrangements.

Long-term care is more than just an insurance policy.

It helps people who struggle to perform daily activities — like dressing, eating, walking, or using the bathroom.
It supports family and social needs.
It prevents health conditions from getting worse.

Where Can I Receive Long-Term Care?

You can receive long-term care services in the following settings:

Assisted Living Facilities
- Live on your own but still receive daily assistance and medical attention.
Nursing Homes or Skilled Nursing Facilities
- Receive comprehensive healthcare services and ongoing medical care.
Continuing Care Retirement Communities
- Move from independent living to more individualized care (for example: meal, transportation, and/or senior center services).
Your Home
- Live at home or with family members while receiving medical care and daily assistance.

Do I Need Long-Term Care Insurance Coverage?

While it's hard to predict when this coverage becomes necessary, it's good to have a backup plan.

Insurance coverage protects you if you get sick, develop severe vision problems, or encounter another sudden need for long-term medical care.

The following factors influence the need for long-term care:

Age — The older you are, the more likely it is that you'll need long-term care.
Gender — Since women typically live longer than men, they have a higher chance of needing long-term care.
Disability — If you have a disability or get in an accident that leaves you disabled, you'll probably need long-term care.
Health Condition — If you or your family have a history of chronic medical conditions or cognitive disorders, like Alzheimer's, you are more likely to require assistance.
Marital Status — Singles are more likely than married couples to need long-term care.

Does Medigap Cover Long-Term Care?

No. Medicare and

Medigap Plans

don't provide direct coverage for long-term care. However, they do cover some services that fall under the long-term care umbrella.

Let's take a look at some examples:

Skilled Nursing Facility (SNF) Care

Insurance might cover your expenses if you need skilled nursing care on a short-term basis (i.e., after an accident/medical procedure).

Medicare — provides full coverage for the first 20 days.
Medigap — covers 50% to 100% of the coinsurance (depending on your plan) for the next 80 days.

Hospice Care

Hospice makes terminally ill patients’ lives more comfortable with physical care, counseling, drugs, equipment, and other supplies.

Insurance coverage varies:

Medicare — covers hospice care only if your hospice provider is Medicare-approved.
- Includes everything needed to manage terminal illness.
- Covers services for any health problems not related to terminal illness but involves deductibles and coinsurance.
Medigap — covers 50% to 100% of hospice coinsurance and copayments (depending on your plan).
- Pays for drugs, respite care, and treatments for problems unrelated to your terminal illness.

Home Health Care

Home health care provides medical care for homebound patients.

Services include:

Physical therapy
Occupational therapy
Speech-language pathology services
Medical social services
Part-time or intermittent home health aide care
Injectable
drugs for women with osteoporosis
Medical supplies for use at home

Medicare covers 100% of these services.

It also pays for most of your

durable medical equipment (DME)

Once you pay the Part B deductible, Medicare pays 80% of the Medicare-approved amount.
Your Medigap plan may cover 50% to 100% of the remaining 20%.

How Do I Get Coverage for Long-Term Care?

You can get long-term care insurance by:

Purchasing it directly from a private insurance company
Connecting to an insurance company through an agent
Buying it from your employer's broker at group rates

Keep these things in mind when shopping for long-term care insurance:

Different insurance companies charge different prices for the same amount of coverage.
Costs vary depending on your age, gender, marital status, and type of coverage.
Shop around and compare policies to find one that fits your needs and budget.

Some of your

long-term care choices

include:

Home and community-based services
Accessory Dwelling Unit (ADU)
Subsidized senior housing
Continuing Care Retirement Communities (CCRCs)
Group living arrangements
Hospice and respite care
PACE (Program of All-inclusive Care for the Elderly)

Conclusion

We all experience aging differently, and it's difficult to predict when unique challenges might arise.

Age-related changes can be scary, but you are not alone. A long-term care insurance plan ensures you have assistance for as long as you need.

If you need help finding a

long-term insurance

provider,

Fair Square Medicare

is here to help! Our experts will help you decide which long-term care plan best fits your individual needs.

Call us today at 1-888-376-2028.

Speak with a Medicare Advocate

Talk to one of our Licensed Medicare Agents today to find the right plans for you.

Your Medicare One-Stop-Shop

Your guide to Medicare Parts A & B, Medicare Advantage, and Medigap. 100% free.

Get the Fair Square Bulletin

Medicare savings tips, helpful guides, and more.

888-454-2383

info@fairsquaremedicare.com

About

Medicare 101

Current Clients

Medicare Supplement Plans

Medicare Advantage Plans

Fair Square 2025

•

Notice of Privacy Practices

Virgil Insurance Agency, LLC (DBA Fair Square Medicare) and www.fairsquaremedicare.com are privately owned and operated by Help Button Inc. Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. This is a solicitation of insurance. A licensed agent/producer may contact you. Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease. Virgil Insurance Agency is a licensed and certified representative of Medicare Advantage HMO, HMO SNP, PPO, PPO SNP and PFFS organizations and stand-alone PDP prescription drug plans. Each of the organizations we represent has a Medicare contract. Enrollment in any plan depends on contract renewal. The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. Plan availability varies by region and state. For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov. © 2025 Help Button Inc

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

MULTIPLAN_FairSquareMedicare_01062022_M

Which Medigap Policies Provide Coverage for Long-Term Care?

Everything You Need to Know About Long-Term Care

Speak with a Medicare Advocate

What Is Long-Term Care?

Where Can I Receive Long-Term Care?

Do I Need Long-Term Care Insurance Coverage?

Does Medigap Cover Long-Term Care?

Skilled Nursing Facility (SNF) Care

Hospice Care

Home Health Care

How Do I Get Coverage for Long-Term Care?

Conclusion

Speak with a Medicare Advocate

Recommended Articles

More of our articles

Your Medicare One-Stop-Shop

About

Medicare 101

Current Clients

Medicare Supplement Plans

Medicare Advantage Plans