There comes a time in our lives when we must address the possibility of our parents and elderly loved ones needing home care. However, many people are concerned that they cannot afford to pay for it out-of-pocket with their limited budget. Who pays for home care services when the family can’t cover the entire cost? This is a difficult reality that most families will have to face, but home care is often the only alternative to placing their loved ones in a nursing home. The good news is that there are plenty of financial aid services that can help cover professional home care expenses.
Senior Care Financial Aid Resources
At FirstLight Home Care, we work with many families with different care budgets and needs. The following is a list of some financial alternatives that can help you pay for home care services.
Medicare
Medicare will pay for professional home care services for eligible senior citizens. In addition to home care services, Medicare covers nursing, physical, occupational and speech therapy services. The downside is that it has very strict criteria that individuals must meet before receiving financial benefits. Medicare home care services are for part-time or intermittent use, so it can be a good option for someone who only needs care a few times a week at home.
Medicare Advantage Plans
Many people will have both Medicare vs Medicare Advantage, as it’s an optional insurance offered by private insurance companies for those already enrolled in Medicare. Often, managed care plans often include coverage for home care services. Medicare Advantage plans are managed care plans for seniors that provide the same benefits as standard Medicare but require prior authorization for home care services. Depending on your plan, you may be required to work with a home care provider that contracts with your plan or be required to provide a referral before receiving home care services.
Medicaid
If an elder is low-income, Medicaid programs will support at-home senior care in most states as an alternative to nursing homes. Medicaid is a joint federal-state medical assistance program that requires states to provide home health services for individuals in certain categories, such as aged, disabled or blind. As each state administers their own Medicaid services, each state has different eligibility requirements. Some programs will provide 24/7 nursing care for those who need it, while others will only cover part-time home care.
Medigap Insurance
Sometimes, even with Medicare’s support, an individual will have gaps in coverage that can leave them unsure how to pay for in home care. Medigap Insurance is designed to bridge these gaps in Medicare coverage. For it to help cover home care costs, a member must be receiving skilled home health care benefits, and the patient’s physician must order this care.
Veterans’ Administration
Through the CHAMPVA program, spouses and dependents of a Veteran who has permanently been disabled or a military member who has died can receive financial help for home care. In addition, veterans who are at least 50% disabled due to service-related injuries and conditions are eligible for home care financial aid. Veteran aid and attendance benefits are for older veterans and their spouses, which provides an increased monthly pension amount to help pay for senior home care. If you or a loved one is a veteran and interested in their eligibility for these services, call Veteran Affairs at 877-222-8387.
Private Insurance
If your parents have private insurance, it should cover some home care services for patients with acute needs. However, longer care plans typically vary by insurer. The good news is that most plans will cover some of the expenses of home care when the patient is responsible for cost-sharing.
Long-Term Care Insurance
Most long-term care insurance programs will cover home care services if specific conditions are met. To determine if these conditions are met, insurance providers use “benefit triggers.” Although there are plenty of various benefits triggers, one common one is whether an individual can perform a certain number of daily living activities without assistance. The downside of long-term care insurance is that individuals are often put on an elimination or waiting period before their home care services can become covered.
Private Pay Home Care
Some people rely entirely on private pay home care. This is where senior care assistance is paid for using savings, pension funds and other existing assets. In many cases, families will use a combination of benefits and insurance as well as their own assets to cover the cost of home care.
At FirstLight Home Care, we can help you get the resources you need to determine who pays for home care services in your situation. Reach out to us about what services your loved one requires, and we’ll provide you with a personalized quote, guiding you through all available payment options you may be eligible for.