Long-Term Care: Medicare and Medigap Coverage

Medicare covers basic medical needs, and Medigap provides some additional coverage, but both were not designed to cover extended long term care. Only limited coverage under two levels of care is offered by Medicare and Medigap.

Skilled Care: Continuous, around-the-clock care to treat a medical condition under supervision of a physician and carried out by trained medical personnel.

Medicare	Medigap
100% coverage for first 20 days if conditions are met	daily co-payment for 21st to 100th day
must have spent min. 3 consecutive days in hospital for same condition
hospital stay must be within 30 days of time entering nursing home
nursing home must be certified facility
daily co-payment for 21st through 100th day
covers expenses beyond daily co-pay limit
no coverage beyond 100th day

Intermediate Care: Needed on an occasional basis (daily or weekly) under supervision of a physician and carried out by trained medical personnel.

Medicare	Medigap
only very specific conditions	additional min. dollar amount per at-home visit
skilled medical care in home	must be ordered by physician as follow-up treatment
only if you are confined to home	no coverage for nursing home facility
no coverage for nursing home facility