Does Insurance Cover Home Care Services?

The cost of in-home care varies across the country and depending on the needs of the individual clients. As you consider and prioritize making home care affordable for your loved one, there are several factors to consider. You have several choices for in-home care, ranging from a nurse visiting several times a week to a live-in care provider who is with your loved one 24 hours a day. In each case, insurance may pay, or it may be more cost-effective to consider assisted care living.


Realistically, the cost of care for your loved one goes beyond how much it cost out of pocket. For instance, over 1.5 million people live in nursing homes around the country and experience an average of 2 million infections a year. These are associated with a high rate rehospitalizations, grief and substantial healthcare expenses. According to the Centers for Disease Control and Prevention, many of these infections include urinary tract infections, diarrheal diseases and antibiotic-resistant staph infections.


On the other hand, helping your loved one stay at home is a gift most elderly and disabled appreciate. According to one survey, one of the greatest concerns of seniors is their loss of independence. Managing life on your own terms is at the very core of human nature. Admission into an assisted care facility may be necessary at times, but the ability to offer your loved one at-home care and retain some of their independence goes a long way towards reducing their risk of depression and rapid physical decline.


Many assisted living facilities do not offer personal care as part of their base fee, but is provided for an additional cost. Home care offers a wide array of services involving aides, therapists and nurses at the client’s residence. Your loved one may require brief assistance to recover from an injury or hospitalization or may need 24-hour supervision.


Options for payment include paying privately, commercial health insurance, Medicare, the Veterans Administration or the Massachusetts Home Care Program. Paying out of pocket is simple and requires very little paperwork. Some commercial health insurance policies will cover home care services when your loved one is recovering from surgery or illness. Long-term care policies almost always cover home care as an alternative to nursing homes as it is more cost-effective for them. Medicare and Medicaid have strict guidelines for their payment processes, and the VA hospital will pay for veterans who are at least 50% disabled due to a service-related condition.


In the state of Massachusetts, you have a state-funded program available called the Massachusetts Home Care Program. If your loved one is over 60 and their annual gross income is less than $2,070 per month, they may qualify for the Massachusetts Home Care Program. They may also qualify if they’re under 60 with a diagnosis of Alzheimer’s disease. The program assigns you a caseworker and helps to evaluate your needs and design an individualized care plan. Although you may be required to contribute a co-payment, these range from just $9 to $130 per month.


Learn More About Your Options

At Anodyne, we’d like to help you design a plan of care for your loved one that meets their needs, reduces costs to their physical and mental health and is cost-effective for the whole family. Contact us today and let’s get started keeping your family safe.