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What Will Insurance Cover in a Long-Term Care Hospital?

What Will Insurance Cover in a Long-Term Care Hospital?

Because care in a long-term care hospital (LTCH) is considered medical care, most insurance policies provide some sort of coverage.  A stay in a LTCH is covered under Medicare, and general you won’t pay more for care in a LTCH than in a normal acute care hospital.  As long as you are:

  • Transferred to a LTCH directly from an acute care hospital
  • Admitted to a LTCH within 60 days of being discharged from an inpatient hospital stay

Insurance coverage in these facilities includes:

  • Inpatient hospital services and supplies
  • Semi-private room
  • Meals
  • Nursing
  • Medications administered during your inpatient stay

In certain situations, and depending on your condition, coverage could also include:

  • Rehabilitation services
  • Pain management
  • Treatment for head trauma
  • Ventilator or respiratory therapy

Coverage under private and commercial insurance plans will be similar to the Medicare policies list above.  However please keep in mind that Health insurance payment options and programs that cover home LTCH are quite complex and regularly subject to change. A patient’s individual insurance policy determines what post-acute care services are covered and paid for. we encourage all patients to consult with their insurance company or administrator for final determination of what post-acute care or long-term care hospital services their policy covers. Learn more about long term care hospitals here.