Helpful Tips to Pay for Home Health Care Services
Medical health care used to be offered in the hospital or at long term health facilities such as nursing homes, but can now be offered in the comfort of your own home. Home health care is cheaper, more convenient and is similarly effective in terms of the service you receive at a medical or long term care facility. The main aim of home health care is to offer treatment and assistance to a loved one to get better and develop a feeling of independence and self-sufficiency while in the comfort of their home.
It is very overwhelming to be the caregiver for a loved one and the easiest option may seem to be to move them to a nursing home. Often forgotten is that your loved ones, our patient, is the person who should have the say of whether to be provided home care or go to a nursing home, if they are able to make this decision. This is the first step of treatment and it involves meeting the patient’s emotional needs. The quality of life provided at home is often better than that at a nursing home. It may be easier on everyone to provide home care than moving into a nursing home. The cost of a nursing home compared to home health care is one factor that is often used to determine where a loved one should be placed. Below we have some helpful provided tips to pay for home health Care services including different avenues that may cover the costs of paying for Home Health Care.
Tips to Pay for Home Health Care Services
There are various ways to pay for home health care. Most people pay for home health care services through Medicare, long-term care insurance and private pay or self-pay.
Medicare will help you receive health care services at home, but it requires you to meet certain credibility. The qualifications to be covered by Medicare are very specific and you must be able to meet the following requirements to be eligible for Medicare home health benefits:
- You must be under the care and supervision of a doctor with a planned schedule of care regularly reviewed by a doctor.
- The doctor must certify that you need either physical therapy or nursing care.
- The agency caring for you must meet the requirements of Medicare.
- It is required that the doctor certify that you be homebound.
After you have met the above qualifications for Medicare, you may be covered for home health care services. However, if you need more help after the qualifications are no longer deemed necessary, Medicare will no longer cover this service.
Wondering how Medicare pays for home health care? Medicare will pay a certified home care agency a payment that covers a 60-day period called the episode of care. The amount of pay is based on the services needed and your loved ones condition. This type of treatment reduces once out-of-pocket expenditure. Note that Medicare will pay only for those services rendered by the certified home health agency. The payment will cover skilled nursing care, physical therapy, occupational therapy, speech-language pathology services, medical social services, and medical supplies. It will not cover 24-hour daycare at home, meals delivered at home, home services like cleaning and personal care like bathing and dressing.
Private Insurance and Long-Term Insurance
Individuals need to contact their insurance carrier to ask what home care services may be covered by their insurance. Not all insurance plans are the same, so this may take some research and phone calls on your part. You would then need to verify that the home care agency you receive services from accepts your insurance. You may also ask if they bill the insurance company or if you have to complete this step. Also your employer may have a program in place that will help cover costs, called Dependent Care FSA. A Dependent Care FSA lets you use pretax dollars to pay for eligible expenses related to care for your child, disabled spouse, elderly parent, or other dependent that is physically or mentally incapable of self-care. Your qualified dependents for a Dependent Care FSA may include:
- Your child/children under age 13.
- Dependents of any age who are mentally or physically incapable of caring for themselves, and whom you claim as a dependent on your federal income tax return.
- An adult may qualify as your dependent if you provide more than half of that person’s maintenance costs during the year.
Ask your HR department if this is a benefit that they offer.
Some individuals have insurance that will pay for nursing home care, assisted living, and in-home care. This is referred to as long-term care insurance. This type of insurance covers costs of home care that Medicare doesn’t cover.
Individuals who acquire this long-term health care insurance are normally not sick. However they are usually unable to perform the most basic activities of daily living, such as bathing, dressing, eating and walking, among others activities. The age factor is not considered in acquiring long-term care insurance
Home care services that may be covered by long-term insurance include assisted living, respite care, hospice care, nursing care, and adult daycare depending on your coverage. Some other benefits of long-term health care insurance include:
- Helps cover the out of pocket expenditures of a caregiver or companion.
- The premiums that are paid are considered as an income tax deductible.
Government assistance is another option to help pay for home care. Medicaid assists those who have low income and resources at their disposal. It is funded by the state government. Those served by Medicaid are citizens of the state. Eligibility for Medicaid coverage is not only income based, there are other categories that qualify an individual for this health care plan. They include: assets an individual holds, age, pregnancy, any disability, and citizenship status.
Other Options to Help Pay for Home Care
There are other ways of paying for home care and they include:
- Reverse mortgages – This is becoming a popular way to pay for long-term home health care. These mortgages are modified in such a way as to pay for a home repair, in-home care, home modification, and any other needs of the patient or the client.
- Veterans Assistance – Veteran administration and attendance pension benefits can help with your purchase of personal care and attendant home services. You may be eligible if you are a veteran, the spouse of a veteran who had been in service for more than 90 days, or is in need of home care due to disabilities.
Self-Pay or Private Pay
Another way of paying for home care is through private pay by an individual using their private funds. The client and the provider of the care negotiate the fees and services. Unlike Medicare, private pay covers those services that are ongoing and long-term for up to 24 hours a day and is generally non-rehabilitative, such as homemaker and transportation services. Private pay home care begins when Medicare ends, and includes any extra services that Medicare does not cover. Many clients will use one agency for Medicare and another for companionship.
Private pay is opted by those seeking more assistance and attention for a loved one with some advantages being:
- The out of pocket expenditures are tax deductible
- You have control over the cost since your care plan is individualized for your loved one based on the services you would like.
Normally, the third party payers’, including Medicare, Medicaid and private insurance, reimburse for skilled care or home health care. Unskilled care is not reimbursed as it is deemed not necessary and is usually paid through private funds.
We hope these Tips to Pay for Home Health Care Services have been helpful for you, and that you have discovered one or more ways to make home care possible for you or a loved one you are caring for. For more information, visit our Home Care Affordability page.