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Will Long-Term Care Insurance Cover My Medical Equipment for In-Home Care?

• Aug - 01 - 2021
• Elixair Medical

Long-term care insurance can provide for many of your medical expenses if you should require professional care later in life. But will it cover the cost of medical equipment that you use at home to treat a medical condition? This article will answer that question, as well as providing more information about what long-term care insurance covers, and other types of insurance that might cover at-home medical equipment.

What Is Long-Term Care Insurance?

Long-term care insurance can pay for a variety of services related to elderly care. In most cases, this does not include actual medical care. Rather, it’s focused on paying for nursing home residency, in-home elderly care, and adult daycare. While It can help pay for the cost of care related to disability, injury, or a chronic illness, primarily, long-term care insurance will only help pay for the cost of custodial and personal care, rather than medical care.

Will It Cover Equipment?

Because at-home medical equipment is considered a medical expense, it’s generally not specifically covered under long-term care insurance, which is more focused on personal, professional services than products. If you require medical products related to your condition, it’s more likely to be covered by your health insurance than by any long-term care insurance plans you might have.

However, long-term care policies can vary. For example, your long-term care policy might provide a daily dollar amount for you to use towards your long-term care. The definition of what falls under that umbrella is often flexible, and you may be able to use your daily dollar amount towards paying for your necessary medical equipment. If you’re ever uncertain about whether or not your long-term care insurance will cover your equipment, you should contact your insurance provider to see if it’s covered. If you’re considering purchasing a long-term care insurance policy, make sure durable medical equipment (DME) is an allowable expense.

What Other Plans Can Cover At-Home Equipment?

So if you can’t rely on long-term care insurance to cover the cost of home medical equipment, which insurance plans will cover it? As mentioned above, this is something that can often be partially or fully covered by your health and medical insurance plan. These include the following:

• Medicare – Medicare Part A may contribute partially to at-home medical equipment, but tends to be a bit more restrictive. Medicare Part B is usually much more flexible and more likely to help with this expense. For both, however, there will likely be a copayment.
• Medicaid – This program will often cover the full cost of home medical equipment, but is only for individuals with very low incomes and limited assets. If you do qualify for Medicaid, however, you can likely have your equipment covered.
• HCBS Waivers – Home and Community Based Services (HCBS) Waivers can be used to cover the cost of equipment and home upgrades related to a disability or medical condition. This is a Medicaid program, and you have to apply for it online. However, if you qualify, it will often cover the costs of your equipment.
• VA Insurance – The VA offers many different programs (grants, insurance, and other assistance programs) to help elderly veterans with the cost of medical equipment. If you have VA benefits, ask a VA representative about these programs.
• State Assistance Programs – Most states have their own programs separate from Medicaid that are designed to assist elderly and disabled individuals with the cost of durable medical equipment for their homes. Some state programs are more comprehensive than others, so research what your state offers to see if it might help you.
• Private medical insurance – Private medical insurance plans vary widely. Contact your plan provider to determine if your plan will help with the cost of medical equipment. In most cases, you should expect there to at least be a copay involved.

All of these different programs can provide some form of help in paying for your medical equipment to use in treating your condition at home.

Purchasing Equipment with Your Insurance Plan

If you have a medical insurance or long-term care insurance plan that covers the cost of your equipment, we’re happy to work with your insurance provider to have your equipment paid for. You will need a prescription from the ordering physician, which should include your diagnosis, the length of time you’ll need the equipment, and the doctor’s name and signature. We’ll bill your insurance for the equipment you need, then collect any remaining portion needed from you.

If you have any questions regarding how we work with your insurance, contact us today!