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Giardini Medicare

Short Term Care

Short-Term Care: Filling Medicare’s Biggest Gap

When most people think about Medicare, they imagine hospital bills and doctor visits. What often gets overlooked is the need for help after a serious illness, surgery, or injury. That’s where short-term care (also called recovery care) comes in.

Medicare does not cover most of the recovery and daily care services people actually need. Yet the costs are real and rising—the average private room in a skilled nursing facility is more than $110,000 per year, assisted living averages $55,000+, and home care continues to climb. With over 70% of Americans over 65 expected to need some type of support, planning for this gap is essential.

Where Medicare Stops

Medicare’s rules are strict:

  • Skilled Nursing Facility (SNF): Medicare covers up to 100 days only if you meet very specific conditions, including a prior hospital stay. Custodial or intermediate care is not covered.
  • Assisted Living: Medicare never covers assisted living.
  • Home Care: Medicare may pay for intermittent skilled home health, but not ongoing custodial or non-medical help.

That leaves a major gap. Short-term care is designed to help fill it.

What Short-Term Care Covers

Short-term care policies provide cash benefits to help pay for recovery needs at home or in a facility. Key features include:

  • Nursing Facility Coverage (includes assisted living):
    • Daily benefit up to $400/day.
    • Coverage periods ranging from 90 to 360 days.
    • No prior hospital stay required.
    • Bed-hold benefits if you’re temporarily hospitalized.
  • Hospital Indemnity:
    • Daily hospital cash benefits (up to $400/day).
    • Helps with expenses beyond what Medicare covers.
  • Optional Home Care Rider:
    • Weekly cash benefits (up to $1,200/week).
    • Pays for professional medical or non-medical services like therapy, personal care, transportation, or meal prep.
    • No waiting period and no prior hospital stay required.

All benefits are paid directly to you (or a provider you designate) in addition to any Medicare coverage you may have.

Why It Matters

Think about common real-life scenarios:

  • Rehab after surgery: You spend weeks recovering in a facility and Medicare’s 100-day rule doesn’t apply—or runs out.
  • Recovering at home: You need professional help several days a week for bathing, dressing, or therapy.
  • Short assisted living stay: A fall or illness means you need assisted living for a few months. Medicare won’t pay, but a short-term care plan can.

Short-term care benefits provide the flexibility to choose where and how you recover—without draining savings.

Who Should Consider It?

  • Anyone age 50–89 looking to protect themselves and their spouse from unexpected recovery costs.
  • People who don’t have a caregiver available nearby.
  • Those who want affordable, defined coverage for recovery needs without the cost or strict underwriting of long-term care policies.
  • Individuals who want predictable cash benefits, not red tape.

Limitations to Know

Like all insurance, short-term care has exclusions. It generally won’t cover:

  • Care outside the U.S.
  • Hospice stays.
  • Mental/nervous disorders, substance use, pregnancy, or experimental treatments.
  • Pre-existing conditions during the first 6 months.

And importantly, this is not a Medicare Supplement, not a long-term care policy, and not a replacement for health insurance. It’s designed to supplement Medicare and other coverage.

Why It Makes Sense

  • Medicare isn’t enough. It doesn’t pay for everyday recovery needs.
  • Cash benefits = choice. You decide whether to use them for home care, assisted living, or nursing facility care.
  • Protection for savings. Even a short recovery stay can cost thousands out-of-pocket.
  • Planning ahead. With recovery costs rising and most people likely to need care, short-term care is a smart, budget-friendly safeguard.

Take the Next Step

We’ll help you:

  1. Review your goals and likely scenarios.
  2. Design a benefit package that fits your needs.
  3. Understand underwriting and eligibility.
  4. Coordinate your Medicare and companion coverage so your plan is complete.

Short-term care helps you stay in control—of your recovery, your finances, and your choices.

Policy features vary by state and carrier. The examples here are based on Aetna’s Protection Series℠ – Recovery Care (Michigan brochure). Always review the outline of coverage before applying.

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