How Can I Pay For In Home Senior Care?
BrightStar Care of Burnsville
For more information about the author, click to view their website: BrightStar Care
Jul 29, 2024
Minnesota - Twin Cities Metro Area
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If you’re like many older Americans –
or you have elderly parents – you probably have a lot of questions, such as:
·
Does Medicare pay for
home health care services?
·
Does Medicare Advantage
cover home care?
·
What’s the average cost
of home health care services?
·
How much does private
in-home nursing care cost?
·
What home care services
does Long-Term Care insurance (LTCi) pay for?
Each person has a unique situation –
financially, health-wise and with family dynamics – so there isn’t a
one-size-fits-all answer to the cost of in-home care services. But we can
provide general insight here and meet
with you one-on-one to discuss your loved one’s specific needs.
Home care can be a cost-effective
option than many people realize and it’s an appropriate use of your loved one’s
income and assets. Just as important – or perhaps even more important – is the
fact that the majority of adults want to age in
place(Opens
in a new window), according to AARP®.
After all, your loved one’s heart is
in their home. If their health allows them to remain at home supported by
high-quality caregivers, finding a way to make that happen is one of the
greatest gifts you can ever give them.
What’s the Best Way to Pay for Home
Care?
Many people that find themselves at
the beginning of the journey to bring caregivers or nurses into their home and
have quite a few questions, such as:
·
“How
much does it cost for in-home care services near me?” The Genworth Cost of Care Survey(Opens in a new window) is
a good starting point for general cost information. Keep in mind that rates
vary based on the types of services and the quality of care.
·
“Does
Medicare pay for home care services?” Refer to item #6 in the Your Plan to Pay for Home
Care section below.
·
“What
resources can we use to cover the cost of in-home care?” This varies for each family and
may change over time as your financial situation evolves.
Answering the questions below can help
you identify sources of funds, which will help you prepare for a conversation
with a BrightStar Care® agency or other home care
service provider:
·
What income, savings and
assets does my loved one have available?
·
Does he or she have
assets they no longer need that could be sold? (e.g. Two cars, but only one of
your parents still drives, a timeshare they no longer use, etc.)
·
Did he or she or their
spouse serve in the military?
·
What health insurance do
they have? What does it cover?
·
Does your family member
have traditional Medicare and/or Medicaid?
·
Does your loved one have
Medicare Advantage (MA)?
·
Do they have Long-Term
Care insurance (LTCi)?
In addition to the resources your
loved one may have available for their own care, consider the availability of
expendable income or assets you and your relatives may be able to contribute
toward your family member’s needs.
What to Ask a Home Care Agency
When it comes to paying an agency,
there are a few questions you’ll want to ask. Although answers to some of these
questions will be included in the agency contract, it’s a good idea to get the
details up-front:
·
What forms of payment do
you accept? (VA/CCN, private insurance, personal check, credit card, Long Term
Care insurance (LTCi), government payers like VA/Military, Medicaid, etc.)
·
How is billing handled?
(mailed, online payment portal, emailed, etc.)
· What are your payment terms? (Pre-pay or deposit, weekly, net 30, due upon receipt, etc.)
Your Plan to Pay for Home Care
There is no single solution that works
for every family. The right solution is the one that works for you. In many
cases, the answer is likely to be a combination of the funding sources
described below.
Except for private pay, most options
for home care services have eligibility requirements and limitations. Because
rules surrounding sources like Medicaid, Medicare and Medicare Advantage (MA)
sometimes change, we can help you navigate evolving details to support your
efforts to provide for your loved one.
1. Private Pay or “Out of Pocket”
Paying with personal funds helps cover
services when you or your loved one’s care has reached the limits of service
and support from sources such as Medicare or other insurance coverage. These
personal funds may come from your loved one or a family member who has the
financial means to share in the cost of home care.
2. Private Health Insurance
Thanks to partnerships with national
and local insurance companies, BrightStar Care® is sometimes in-network. Call us for more information
– we are happy to do our part to facilitate getting quality care for your loved
one.
3. Long-Term Care Insurance (LTCi)
Long-term care benefits usually pay
for in-home assistance with “activities of daily living” (ADLs) such as
bathing, dressing, incontinence care, transfers (from bed, chair, toilet,
etc.), meal prep and more. If your loved one has LTC insurance, BrightStar Care
can help you process the claim; in some cases, we can assist with billing.
4. Military Benefits
VA health care benefits are available
for eligible veterans and some benefits extend to the veteran’s spouse.
Additional programs such as Aid & Attendance provide monetary funding to be
used for home health care. Eligibility requirements vary so it is important to
research which veterans programs(Opens in a new window) may
be a good fit. Call your local BrightStar Care agency today and they’ll help
you determine if your loved one is eligible.
5. Medicaid
Each state decides what services are
provided under their Home and Community Based Service
(HCBS) waiver program(Opens in a new window). To qualify, your loved one must meet
your state’s eligibility requirements, and have income and assets below certain
guidelines. You can find general details about Medicaid here(Opens in a new window) or
your local BrightStar Care team may have additional insights.
6. Medicare (Traditional/Original)
Medicare Part A (hospital insurance)
and/or Medicare Part B (medical insurance) cover eligible home health services
as long as you need part-time or intermittent skilled services and as
long as you meet the standards of homebound, as defined by the U.S. Centers for Medicare and Medicaid Services(Opens in a new window).
Medicare Part B (medical) covers some
in-home care, but the type of service and frequency may be limited.
Medicare-certified home health agencies provide service based on orders from a
physician or allowed practitioner (such as a nurse practitioner, a clinical
nurse specialist and physician assistant) usually for a specific condition and
a set period of time.
Medicare Part A (hospital) offers the
same coverage as Part B. However, under Part A, you may not receive home health
services unless you were hospitalized for three (3) consecutive days just prior
to needing at-home care.
BrightStar Home Care locations that
offer skilled nursing may be eligible to provide “medically necessary part-time
or intermittent skilled nursing care.” If your loved one is currently receiving
care from a Medicare home health agency, BrightStar Care
(which is a home care agency) will work with the Medicare
agency to provide the supplemental or continued care.
Every situation is different. You may
be affected by a Medicare demonstration program if you receive services in
Florida, Illinois, Massachusetts, Michigan, or Texas. Learn more with a free
booklet, Medicare and You,(Opens in a new window) from
the official Medicare website. This booklet is available in multiple languages(Opens in a new window),
Braille, audio, large print, e-reader options and on paper. You can also visit
the home page of the Medicare site(Opens in a new window) or
call 1-800-MEDICARE (1-800-633-4227).
7. Medicare Advantage (MA)
Medicare Advantage (also called
Medicare Part C) is an alternative to traditional Medicare(Opens in a new window) for
your healthcare insurance that often includes benefits not covered by
traditional Medicare, such as dental, vision, drug coverage and supplemental
benefits like personal care and homemaker services.
There are many insurance carriers and
MA plans available with differing benefits, so it is important to understand
what coverage you have. Our team is here to help you sort through details
regarding whether you may qualify for In-Home Supplemental Services (IHSS).
8. Program of All-Inclusive Care for
the Elderly (PACE)
This newer, relatively small program
may be a source for home care funds. PACE(Opens in a new window) provides
comprehensive medical and social services to certain frail, elderly people
(participants) still living in the community. Most of the participants who are
in PACE are dually eligible for Medicare and Medicaid.
Lean Into Our Experience
Most individuals will only deal with
home care services a handful of times throughout their lives – for their
parents, their spouses, a child with a disability or even themselves.
But at BrightStar Care, we think about
home care services 24/7, every day of the year. We are ready to be your trusted
source of information and guidance on this important issue. We hope you’ll
reach out for assistance.
If you would like to learn more about in-home care, please send us a message, reach out to your nearest BrightStar® Home Care agency at 612-488-4159
- To view the original version of this article visit www.brightstarcare.com/home-care-guide/cost-of-home-care/
- Seniors Blue Book was not involved in the creation of this content.
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