You don’t expect to end your errands in the emergency room. But for millions of older adults, a routine day where you live can quickly turn into a medical emergency. One misstep, and you're in an ambulance—followed by surgery, hospitalization, and rehab — or worse, the need for long-term care.

After the shock wears off, the reality hits: who’s paying for all this?

If you're on Medicare, the answer may not be what you expect. While Medicare covers hospital stays and some short-term skilled care, many critical recovery services—including rehabilitation, follow-up visits, and long-term care—could leave you holding the bill.

I thought Medicare would handle everything after my dad’s fall,” said Julia M., a daughter from Naperville, Illinois. “But we were shocked to learn how quickly coverage dropped off after rehab started. We had to hire home health aides ourselves.

After an accident happens, you have a series of steps to go through, and it can quickly become challenging. Let's break down what you need to know if you or a loved one experiences an accident, especially if you're over 65 and relying on Medicare and a supplement or Medicare Advantage.

A typical accident recovery journey includes:

These services may be billed under entirely separate categories—and not all are covered under the same health plan, especially if you cross from one city or provider network to another.

For example, if you’re injured in a bicycle crash in Aurora, Illinois, but live in Joliet, Illinois, care continuity can quickly get tangled in coverage red tape. Depending on the plan, crossing into a different provider network can affect what’s covered and what’s not. 

Most assume Medicare will cover whatever care is necessary after a fall, fracture, or surgery. But that’s only partly true.

However, . If you need help with bathing, dressing, using the bathroom, personal hygiene, or daily supervision at home or in a facility after a serious injury, you'll be paying unless you have Long-Term Care Insurance.

There are private plans that combine Parts A, B, and usually Part D for prescriptions into one. You might get extras like dental or vision, but there’s a downside. Most Advantage plans use networks like HMOs or PPOs, which means you’re limited to certain doctors or hospitals. 

Medigap is useful if you value freedom of provider choice and fewer billing surprises, especially for those living in smaller towns like Decatur or Moline, where access to large provider networks can be limited.

Let’s say you suffer from a hip fracture. After surgery, you may qualify for Medicare-covered rehab at a skilled nursing facility. But that coverage only lasts up to .

After that? You're on your own unless:

After my mother’s stroke, the rehab center told us Medicare stopped paying after 21 days,” said Tom L., 49, from Burr Ridge, IL. “She still needed daily help, and we had no idea what to do. Her Long-Term Care Insurance saved us.

“Many of my clients reach out after witnessing a loved one struggle with extended care needs following an accident, fall, or a dementia diagnosis,” said Laura Peery, a Long-Term Care Insurance specialist and Dave Ramsey Trusted Pro.

When they describe how hard it was to see someone they love lose their independence and need daily assistance, it reinforces why planning ahead is so important.

Peery, who is associated with Platinum LTC Solutions, a leading group of specialists in long-term care planning,  says there is a drastic depletion of the family's emotional and financial resources because they did not have a well-crafted "Aging Plan" to meet the care needs in retirement years. 

When I meet with clients, we design an aging plan that includes an LTC policy to help cover the cost of care, and bring clarity to the fact that Medicare does not pay for long-term care.

Without this type of insurance, families must often deplete retirement savings or rely on unpaid caregiving—usually from adult children already balancing work and their own families.

The cost of long-term care services varies nationwide. For example, long-term care costs in Illinois are higher than they are in Tennessee. Within a state, the cost of extended care services can also vary.

According to the LTC News Cost of Care Calculator

And those are just averages. Costs rise sharply in metropolitan areas like Chicago, Washington DC, and San Francisco—and they're rising every year.

If you don't have Long-Term Care Insurance or qualify for Medicaid, these expenses will come out of your personal savings or family contributions.

This is why many people apply for Long-Term Care Insurance before they retire, so it is in place when they need it.

Healthcare emergencies aren’t something you can schedule. But you can plan for the financial side. Long-Term Care Insurance offers a safety net that Original Medicare, Advantage, and Medigap do not.

“Most people secure coverage in their 50s or early 60s while still in good health,” says Linda Weyer, a recognized expert in long-term care planning.

It’s a proactive step that eases the burden on your family and protects your lifestyle, no matter what happens.

Experts like Peery and Weyer suggest getting accurate LTC Insurance quotes from specialists with experience in this type of insurance and representing the top-rated insurance companies offering long-term care solutions.

A broken wrist or a torn ligament might heal—but the financial pain can last a lot longer if you're not prepared. Medicare helps, but it has limits. Medicare Advantage and Medigap fill some gaps—but not the biggest one: extended care when you need help long after the hospital stay ends.

Don’t wait until you’re in the ER to find out what your plan covers. Review your options now—especially if you're on Medicare—and make sure you’re protected for the long road to recovery.

• Find qualified Long-Term Care Insurance Specialists

Use the LTC News Caregiver Directory to locate home care providers, assisted living, memory care, and nursing homes near your loved one.