If your parent or other senior loved one is not as capable of being completely independent anymore, you are most likely thinking about the next level of care for them. First and foremost of course, you’ll base your decision on their specific needs.
But, you’re also likely wondering about how much in-home care costs, because you have to consider the financial aspect of it. The good news is that it costs considerably less than the expense associated with nursing homes or assisted living facilities.
So, how much does in-home health care really cost? Everyone’s situation is unique, but we’ll map out for you the average in-home care costs, the services that are typically provided, and funding options.
Quick Cost Guide
- Nursing home with a semi-private room – $92,710*
- Assisted living facility – $56,700*
- In-Home Care – $37,440*
In-Home Health Care Costs Vary From Client-to-Client
Every client has their own special circumstances which will factor into the cost of in-home care. The costs will also vary depending on the region, the services needed, plus the frequency and duration of the care.
For example, the annual care costs for a client who requires driving services only once or twice a week will be vastly different from the client who requires daily meal preparation or overnight assistance.
Below, we will provide information about annual cost averages for different types of care, along with a list of the services provided by licensed home health care agencies. As you review the information, keep the idea of quality-of-life costs in mind as well.
The truth is, most seniors would much prefer to stay in their own homes rather than move out to an unfamiliar facility. By providing in-home health care, you are helping them feel safe, secure, and independent in the home they love. Their routine can remain the same and they won’t be subjected to the restrictions or “rules” that are often set in place by alternative care options.
If you’re considering in-home health care as an option for yourself or a loved one, it makes sense to schedule free assessments with top agencies in your area. The assessment is critical not only to establish the types of services that are needed immediately, but also to create a comprehensive long-term plan as well.
The assessment will provide cost predictions and analysis based on your specific needs. Additionally, our agency will offer recommendations for how to keep the current environment safe and accessible for your senior loved one.
If you plan to use Medicare or Medicaid to pay for these costs, make sure the agency is Medicare-approved before scheduling an appointment.
National Average Costs of Care By Type
The Federal Long-Term Care Insurance Program keeps track of long-term care costs across the nation. Their information is based on at least six hours of professional care, five days a week.
The average, at-a-glance costs for the three most common types of care for seniors are as follows:
- Nursing home with a semi-private room – $92,710*
- Assisted living facility – $56,700*
- In-Home Care – $37,440*
In-home health care costs will escalate as a client’s needs increase, but this is also the case for both nursing home and assisted living facilities since their base prices do not reflect additional care, laundry services, medical costs, etc.
The same agencies that provide in-home care are also willing to extend aspects of their services into the assisted living and nursing home arenas, providing things like companionship, medication reminders, driving services, and so on.
What is Offered by In-Home Health Care Agencies?
In-home health care agencies are dedicated to providing high-quality care from trained caregivers, which supports the physical and emotional well-being of our clients in the comfort of their own homes.
This personalized, client-centric care paradigm keeps seniors more content, comfortable, and independent. The most frequently requested services include:
- Driving services to doctor appointments, social engagements and religious services and activities
- Daily grooming, bathing and hygiene care, including incontinence care
- Bill paying and general administrative – including IT support
- Medication reminders
- Housekeeping and errand running
- Grocery shopping and meal preparation
- Overnight or live-in care
- Respite care (to give regular caregivers much-needed time off)
How to Take Advantage of In-Home Health Care Services
Working with a trusted physician is one of the best things you can do to take advantage of services while being mindful of your budget.
Once you’ve clarified coverage options from Medicare or Medicaid and any existing private insurance, the physician can advocate on your behalf for which in-home health services should be implemented.
In certain cases, immobility or other health issues may allow the cost for an in-home aide (separate from medically-oriented home health care services) to be covered for a short time until certain medical conditions are under control and the individual regains the ability to perform basic physical functions (bathing, toileting, grooming, etc.)
Once you and the physician(s) have come up with a list of services required, schedule at least two or three free, in-home consultations with licensed home care agencies. During these consultations, agency representatives will also explain which services can be billed through insurance and which are billed out-of-pocket.
In-home care agencies can also assist you with creating a long-term care plan, which is instrumental in providing peace of mind, plus a step-by-step protocol for how to proceed as the needs of the client evolve over time.
After meeting with a few different agencies, you’ll have a clear idea of which one best suits your needs and makes you feel the most comfortable. The good news is that this isn’t an either/or scenario; home care aides and home health care professionals often work collaboratively to provide the most efficient, beneficial and comfortable care for their clients.
Financing the Costs For In-Home Health Care
The good news is that financing in-home health care is easier than you might think. Here are some of the most common ways seniors and their families fund home health care services.
Medicare (Parts A and B) and Medicaid
Medicare is available to those 65-years or over and/or adults with severe disabilities. As a federally funded program, it covers the total costs of medically related in-home care, as well as 80% of medical equipment costs (such as oxygen tanks, mobility aids, hospital beds, etc.).
The caveat is that the services required must be prescribed by a physician or appropriate, licensed health care specialist. Additionally, the senior’s needs and progress are assessed continuously over time.
How to Apply for Medicare
Most individuals eligible for Medicare are contacted via mail by Medicare.gov. It’s important to enroll during the initial enrollment period if possible to avoid any potential penalties. Here’s what you need to know about Medicare’s initial enrollment period:
- It begins 3 months before your 65th birthday
- It continues for 3 months after your birthday
- It lasts for 7 months
There are many ways to enroll yourself or to help a loved one enroll by:
- Starting the application online with the Social Security Administration at ssa.gov.
- Calling the Social Security Administration at 1-800-772-1213 to speak to a representative directly.
- If you are deaf or hard of hearing, you can reach SSA at TTY 1-800-325-0778.
- Making an appointment at your local SSA office (click here for a list of locations).
Medicaid has stringent, low-income qualifications but those who qualify are also entitled to subsidized and/or receive full-coverage options for in-home care services as long as the services are based on medical needs.
Medicare Advantage Plans (Type C and D)
If you pay for a Medicare Advantage Plan, you may have more options available to you, but these all depend on the type of plan you select.
Medicare Advantage Plans come with monthly premiums that reflect the level of coverage offered by various plans. These plans are provided by private insurance providers that contract with the government.
We recommend making an appointment and speaking directly with an SSA representative to learn more about Medicare Advantage Plans, Part C or Part D, and whether or not they are a good option for you.
How to Apply For Medicaid
Medicaid coverage and eligibility are handled by the U.S. Department of Health and Human Services. Stringent, low-income qualifications must be met, but those who qualify are also entitled to subsidized and/or full-coverage options for in-home care services—as long as the services are based on medical needs.
Coverage and eligibility vary from state to state based on cost-of-living analyses, annual income, family size, etc. Click here to complete information that will determine whether or not you or your loved one may be eligible for Medicaid in your particular state..
If you feel you are eligible, you can apply for Medicaid assistance one of two ways:
1. Click Here to view eligibility requirements in Virginia. If you live elsewhere, simply use the drop-down menu at the right of the page to select the state where you or the interested applicant lives.
2. Fill out the form on the Health & Human Services Marketplace page. The information provided will trigger an assessment of whether or not the applicant qualifies for Medicaid.
Private Health Insurance Plans
Because in-home health care is more affordable than its nursing home or assisted living facility counterparts, insurance providers are taking note and are slowly expanding their in-home care coverage options. You may be surprised at the types of in-home health services available to you via your private health insurance policy.
Call your plan’s customer service representative to find out which types of services are subsidized or covered, and what requirements are necessary to qualify. As with Medicare, you may need a referral or recommendation from a physician or specialist.
Long-Term Care Insurance
If you’re planning ahead, you’re in luck. Long-term care insurance policies can be a wonderful option for financing the care expenses you’ll incur down the road. As you might imagine, the younger you are when you purchase your policy, the more affordable the monthly premium will be.
We recommend meeting with a trusted financial advisor or insurance representative to make sure you buy a plan that will deliver for you, and that makes sense for your projected needs.
As with all insurance policies (you never want to be inadequately nor over-insured) it’s always best to strike that middle ground.
As a result of the 2008 financial crisis, reverse mortgages came under rigorous scrutiny. However, the recent tightening up of lender loopholes and the stabilization of the real estate market make these, and similar equity lines of credit, viable options for many senior homeowners.
By taking out just what you need, you can finance the remainder of your in-home health care costs for the next five, ten or twenty years.
Ultimately, these mortgage plans view your home as a retirement investment. So once you sign on the dotted line, it’s almost the same as making a withdrawal on years of retirement investments, as you would with a traditional IRA, money market, 401(k), etc.
Again, you should speak with a certified financial planner or a certified public accountant before making any significant changes in your financial plan.
The Department of Veterans Affairs (VA) offers several different programs to cover or offset the cost of in-home care. The most widely-used are the Improved Pension, Homebound and Aid and Attendance funds.
Life Insurance Conversions
If you or a loved one are still paying monthly premiums for a life insurance policy, you may be eligible for a life insurance conversion. There are a few different options, depending on your plan.
Always consult with a qualified, licensed insurance agent before making any permanent decisions regarding your policy.
Affordable, Professional In-Home Care is Possible
As you can see, in-home care is a viable option for your senior loved one. For additional help exploring the costs of home health care for yourself or a loved one, just click below.