BackPayment Options for Professional Care at Home
The following information was taken from an article by James Contos, published in the Seniors Blue Book - North Metro Denver, 2007-2008
As professional care at home becomes more prevalent, many are asking, "Does my insurance or Medicare cover the cost of care at home?"
Most long-term care insurance will cover a portion of home care. Generally it pays for personal type care and not medical care. Check your benefits carefully.
Private insurance is beginning to embrace home care (as its use has increased over the past few years). Benefits may vary widely between carriers.
Medicare may also be a payment option, if the following criteria are all met.
- You must need intermittent (and not full time) skilled nursing care, physical therapy, or speech language pathology services.
- You must be homebound. Being homebound means that leaving your home is a major effort. Leaving home must be infrequent, for a short time, or to get medical care.
- The home health agency caring for you must be approved by the Medicare program.
- Your physician must approve your plan of care. Most home health providers will call your physician, on your behalf, for approval.
If home care is provided under Medicare, the cost of services is covered completely. You can go on and off Medicare home health as many times as needed.
State Medicaid home care is covered 100%, but these programs generally have income qualifications. They also have guidelines for approval, but often can be for longer periods of time, not just intermittent care.