Supplemental coverage › Home health care › Dorothy’s example
Real-life example · Home health care
Dorothy recovers at home: how the money works
Available under 65 and 65+
Dorothy, 77 · hip replacement · 6 weeks of recovery
After hip surgery, Dorothy’s doctor certifies in writing that she can’t bathe or dress on her own for a while. That’s the trigger. She recovers at home instead of a rehab facility, and her policy pays her a set amount for each kind of care she gets, in addition to whatever Medicare pays.
What happened
Follow the money
Add up what the policy pays Dorothy
What makes up Dorothy’s benefits
The takeaway
A typical week (5 aide days at $50 plus 2 therapy visits at $75) adds up to $400. It’s paid on top of Medicare, and the check goes to Dorothy, not the agency. She used part of it to cover her daughter’s gas for the daily drive over.
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.