Supplemental coverage › Home health care › Frank’s example
Real-life example · Home health care
Frank goes to adult day care: how the money works
Available under 65 and 65+
Frank, 81 · early dementia · policy bought years earlier
Frank’s doctor recommends an adult day program so he has supervision while his wife works part-time. He goes three days a week, at least four hours a day. His policy pays $75 for each day he attends, up to 90 days a year.
What happened
Follow the money
Do the math
90 days of benefits, each square = $75
90 squares × $75 = $6,750 a year. At 3 days a week, Frank fills all 90 in about 30 weeks.
The takeaway
The timing matters: Frank’s wife bought this before he needed care. Once someone is already receiving home care or living in a facility, they usually can’t qualify. Conditions treated in the 6 months before the policy starts also aren’t covered until it’s been in force for 6 months.
These are illustrative examples with made-up names. Dollar amounts come from one sample plan design and are shown only to explain how the benefits work. Your actual benefits depend on the plan and options you choose, your state, and the terms, limitations, exclusions and waiting periods in your policy.
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This page is educational and is not an offer of coverage or a recommendation of any specific policy. The policies described are individually underwritten supplemental (indemnity) insurance. They are not major medical coverage, not Medicare Supplement insurance, not long-term care insurance, and not “minimum essential coverage” under the Affordable Care Act. Benefits, benefit amounts, riders, availability and eligibility vary by state and are subject to the terms, limitations, exclusions, waiting periods and pre-existing condition provisions of the actual policy and its outline of coverage. Senior Benefits Hub is an independent insurance agency; licensed since 2013. Not affiliated with or endorsed by any government agency.