Care after a hospital stay, at home or in a facility.
After a fall, a surgery or a hospital stay, some people need help for a while: care at home, or a stay in a nursing home or assisted living. These policies can pay you a set amount for each day you get that care. I'm Erick Vallarino, an insurance agent here in the Valley, and I help people anywhere in Texas.
These are limited benefit policies, not Medicare plans.
They pay a set amount for each day of care, for months, not years. They are not major medical coverage, Medicare Supplement insurance or long-term care insurance, and they do not replace Medicare or your health plan. You don't need one to have Medicare. I look at what you already have first, and if one wouldn't help you, I'll tell you.
What Medicare covers, and what it doesn't.
Medicare Part A can cover care in a skilled nursing facility for a short time, 100 days at most in each benefit period. You usually need a qualifying inpatient hospital stay of at least three consecutive days; observation time does not count. Some approved Medicare arrangements and Medicare Advantage plans can waive that stay requirement. Ask your provider or plan. You must also need daily skilled nursing care or therapy. After the first 20 days, you pay a daily amount. Medicare Advantage plans cover it too, with their own rules.
Medicare can also cover some skilled care at home, like visits from a nurse or a therapist, when leaving home takes a lot of effort for you and a doctor says you need it.
Medicare doesn't pay for long-term care, like help with bathing, dressing or using the bathroom, when that's the only care you need. Medicare Supplement plans don't pay for it either.
These policies are one way to help with the costs of care for a while, whatever coverage you have. They pay you, and you decide how to use the money.
Two kinds, in plain words.
Each policy lists what it pays for and when. Often a doctor or another licensed health professional has to say you need help with everyday things, like bathing or dressing, or need care because of memory problems. We read the details together.
Short-term care
It pays you a set amount for each day you're in a nursing home or assisted living for a while, like after a surgery or a fall. It's built for months, not years.
Home health care
It pays you a set amount for each day you get care at home, like after a hospital stay. The care may have to come from a licensed home health agency.
I work with several insurance companies and put your choices side by side, in English or Spanish, at your kitchen table, at an office near you, or by phone or Zoom if you live farther away.
Questions I'll help you ask.
We go over these together, for every policy, before you sign anything. If we're meeting about your Medicare and you'd like to talk about these too, just tell me when we set the time.
- When does it start paying?Some policies wait a set number of days first.
- How many days does it pay?Every policy has a limit.
- Does it pay if a family member takes care of me?Often it pays only for care from a licensed agency. Ask.
- Does it ask health questions?Your answers can decide if you're approved.
- Can the price go up later?Ask now, not after you sign.
- Do I already have something like this?We check first.
Want a quote? Let's talk it over.
Call or text me. We'll look at what you have now and what worries you most, in person, by phone or on Zoom. No pressure, and asking costs you nothing.