Financial Resources for In-Home Care

A variety of programs can help make it possible to bring a qualified caregiver into your home.

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- Posted on Mar 20, 2020

An in-home caregiver helping an elderly man in a wheelchair.

Editor's note: Please check with your healthcare providers and your own insurance policies, as well as with Medicare to confirm coverage and requirements.

As many people are not able to visit their loved ones, some may be thinking about whether an in-home caregiver might be a good option. While there may not be an immediate way to address the situation, this time when many people are spending more time at home can be an opportunity to investigate the options for financial support to help with costs of in-home assistance.

This is a major consideration unless you’ve got adequate savings or investments, or your loved one was able to purchase a good long-term care policy early on. According to a 2019 survey by the insurance company Genworth the national monthly median cost for in-home homemaker services is $4,290, and for a home health aide it’s $4,385. Many people find themselves reaching deep into their pockets and patching together funds from other sources like life insurance policies and annuities. They may take out potentially risky reverse mortgages or home equity lines of credit. Determining what sort of care your loved one needs and how to cover it may be daunting, but there is a great deal of help available, and you don’t have to figure it out on your own.

A good place to start is with the U.S. Administration on Aging’s Eldercare Locator, a nationwide service that connects older Americans and their caregivers with trustworthy local support services. You can use it to find your local Area Agency on Aging for more information on paying for home care services. Or type your loved one’s zip code into the National Council on Aging’s BenefitsCheckUp site to find out whether he or she qualifies for any benefit programs. Assistance is available on many fronts.

It’s important at the outset to understand the distinction between the two types of home care, and that financial assistance varies for each. Home care aides provide companion care and help people with the activities of daily living, such as bathing, dressing, transportation and housekeeping. Home health aides provide care such as checking pulses, temperatures or respiration and assist with medications, braces, ventilators and other medical equipment.

If you and your loved one need additional help to handle the costs of in-home care, exploring the following government programs can help greatly:

Medicare

Traditional Medicare does not pay for non-medical care, so home care is not covered. Medicare Supplemental Insurance plans generally don’t cover home care either. Medicare does offer limited coverage for a variety of home health services, as long as the patient is under a doctor’s care and the doctor certifies that the care is needed. These may range from changing wound dressings to monitoring food and medication intake. To find out whether your loved one qualifies, go to https://www.medicare.gov/coverage/home-health-services.

Depending on where your loved one lives, another option to cover costs of home and home health care is the Programs of All-Inclusive Care for the Elderly (PACE) program. Currently available in 31 states, PACE is an optional Medicare and Medicaid program for older adults who need nursing home-level care and who are able to live safely in the community with help from PACE.

New in 2019, the Centers for Medicare & Medicaid Services (CMS) announced it was broadening the range of supplemental benefits Medicare Advantage (MA) plans can offer in 2020. As of this year, health care policy makers will allow MA plans to cover any benefits that “have a reasonable expectation of improving or maintaining the health or overall function” of beneficiaries with chronic conditions. This could mean that several in-home services, such as home health aides, personal care assistance, palliative care and meal delivery will be covered.   

Medicaid

Medicaid pays for non-medical home care, home health care and other in-home supports to help people who qualify for the program continue living in their homes. Eligibility and benefits vary by state.

VA programs

The Department of Veterans Affairs (VA) offers a variety of options through its Home and Community Based Services program. These include Homemaker & Home Health Aide Care, Skilled Home Health Care, Home Based Primary Care and Veteran-Directed Care services. Qualified veterans and their surviving spouses may also be eligible to receive monthly payments on top of their VA pension via Aid & Attendance benefits or a Housebound allowance.

Take heed in knowing that there are many possibilities for the financial help that you and your loved one may need. Finding a way to bring a qualified caregiver into your home can bring you both a peace of mind you may not have realized was possible.

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