Getting home care services allows those who need help with activities of daily living (ADLs), to take their medication, or provide companionship while they remain at home can be beneficial. However, the cost of home care can be about thousands of dollars.
Yet, luckily there are different financial assistance programs for home care and other resources that are designed to pay for home care services, benefiting the patients and their families. This guide will inform readers on which programs are offered to help pay for home care services.
1. Understanding Home Care Costs
Types of Home Care Services
Home care services can vary widely, including:
- Personal Care: help with activities of daily living (ADL) including bathing, dressing, eating, and so on.
- Home Health Care: Services provided to patients in their homes by licensed professionals, such as nurses, physical therapists, and others.
- Companionship Care: Social support and non-medical assistance to reduce isolation and provide companionship.
Cost Factors
The cost of home care services depends on several factors, including:
- Care Level: Medical care is more complex to deliver than personal care. So, medical care tends to be more expensive than personal care.
- Duration/Frequency: Costs can vary depending on how many hours of care per week are needed.
- Location: Prices can differ based on geographic location and the local cost of living.
2. Government Programs
Many government schemes offer financial support for home care assistance. For example:
Medicare (U.S.)
- Coverage: Medicare covers home health care service if the claim is made under Part A and if the patient is eligible. Medicare Part A covers home healthcare services that meet certain requirements. To receive coverage, it must be prescribed by the patient’s doctor and aimed at helping the patient recuperate to a level where they no longer need skilled nursing care. This care may include skilled nursing care, physical therapy, speech-language pathology, and help from a home health aide.
- Eligibility: Any individual who is enrolled in Medicare or has a medical order for home health services provided by your doctor, and who is deemed to be ‘homebound’ and in need of skilled services may be eligible.
- Limitations: Medicare does not cover long-term non-medical home care or personal care services.
Medicaid (U.S.)
- Coverage: Personal care (such as getting in and out of bed or dressed, bathing, dressing) and home health – including nursing, physical therapy, and other treatments – services offered through Medicaid vary depending on the state.
- Eligibility: Individuals must meet income and asset caps by state. States can also offer additional services through a practice called Home and Community-Based Services (HCBS) waivers.
- Caveats: Some states have long waiting lists for HCBS programs, or are limited financially in their support.
Veterans Benefits (U.S.)
- Care-giving benefits: The VA offers several programs to help defray home-care costs, such as the Aid and Attendance Benefit and the Home and Community-Based Services (HCBS) program.
- Eligibility: You must be a veteran of military service or have an income and need for care. To qualify for benefits through these programs, veterans or their spouses may be eligible.
- Limitations: Benefits may have specific requirements and caps on coverage, depending on the program.
Other Government Programs
- State and Local Programs: Many states have either state-funded or state-protected programs that will pay for home care. For instance, some states have ‘waivers’ that allow limited types of home care for Medicaid beneficiaries who require more extensive services than their regular benefits provide. Several local governments and medical centers also have programs like senior services or agencies that assist.
3. Insurance Options
Various types of insurance may help cover home care costs:
Long-Term Care Insurance
- Benefits: Long-term care coverage pays for in-home care services, such as personal care and home health, depending on the type of
- Eligibility: Must apply for and purchase coverage before access to care is needed.Benefits: Covers only what’s stipulated in the policy.
- Limitations: Policies may have waiting periods, benefit limits, and exclusions.
Health Insurance
- Coverage: Home care can sometimes be covered by some health insurance plans, depending on the specifics of the individual plan. Just skilled nursing and/or therapy may be covered.
- Eligibility: Valid for any screenings subject to the terms of your insurance policy. May require pre-authorization and/or meet certain criteria.
- Limitations: Long-term non-medical home care or personal care services are not covered by health insurance.
4. Non-Profit and Community Resources
The following private, non-profit, and community resources might offer some kind of financial help or be able to provide referrals for home care:
Non-Profit Organizations
- Programs to help fund home care: For-profit and non-profit local agencies, such as Area Agencies on Ageing (AAA), as well as other local not-for-profit organizations, might offer grants, subsidies, or service programs to support home care.
- Services Offered: Such groups can provide you with financial support, case management, or referrals.
Community and Faith-Based Programs
- Local Resources: Community and faith-based organizations also offer ‘volunteer’ services, fundraising, and direct financial assistance to people.
- Types of Assistance: Assistance may include meal programs, transportation services, or temporary financial aid.
5. Personal and Family Resources
Savings and Investments
Self-funding Through personal savings, investment portfolios, or retirement savings accounts – as we learned, planning and budgeting are critically important to managing such funds.
Family Contributions
Family support: Relatives can help financially or network resources to pay for home care Open communication and planning between relatives and other family members can also help with co‑ordinating and cost sharing.
6. Planning and Application
Research and Compare Options
Programs: look into financing and insurance programs to see which is best for you and which you qualify for. Compare coverage, cost, and eligibility requirements.
Gather Documentation
Start Paperwork: You can start by gathering together any proof of income, medical records, and other documents you might need for an application for financial assistance.
Apply for Assistance
Complete applications for need-based financial aid programs, insurance claims, or with a non-profit organization. Follow up on submitted applications to ensure consideration and approval.
Seek Professional Advice
Seek Out Advisors: Ask a financial planner, an elder law attorney, or a case manager (someone who manages care for seniors) for advice on how to approach financial aid and manage home healthcare costs as well.
Home care services can be expensive, and many people and families rely on government programs, insurance, non-profits, and their funds to help pay for them. Planning, research, and applications can make a big difference in the care you receive. Understanding your home care insurance and its options knowing about the treatments you are considering, and creating a skilled nursing home plan are all important steps to secure the care and financial resources you need while remaining as comfortable and independent as possible at home.
