Paying For Senior Care: Medicare, Medicaid, and Home Care

daughter researches paying for senior care with mother

Prospective clients often ask us whether Medicare benefits will cover in-home care.

Medicare only provides benefits available for skilled home care services for seniors who are homebound and cannot easily travel to and from outpatient rehab services. The home health benefits require you to be under the care of a doctor who has established a care plan for you.

The doctor must sign off on either:

  • part-time skilled nursing care
  • physical therapy
  • speech therapy
  • occupational therapy

Your home care agency will have to be Medicare-approved for these services. Before starting care, you should work with your doctor and the home health agency to be sure you know what services and supplies Medicare will cover, and what you will have to pay for yourself.

PLEASE NOTE: While Medicare covers skilled care as needed, it is very rare that anyone receives compensated, non-skilled care for more than one- to two hours per day. Therefore, families should create a budget that includes in-home care services paid for via other forms of assistance (continue reading below) – including out-of-pocket payment options.

Medicare does not cover 24-hour home care, personal care, or homemaker services. However, you may qualify for assistance with these services under Medicaid. In most states, Medicaid covers services that help you remain at home. You must be Medicaid-eligible and need assistance with multiple activities of daily living such as bathing, dressing, using the bathroom, and eating.

Visit Medicare.gov for more information about Medicare, and the Department of Health and Human Services for information about your state’s Medicaid programs.

Paying For Senior Care Services

Over the years, we’ve found that proactive research and diligent planning ensures our clients can comfortably pay for qualified, in-home senior care services without having to rely on 100% out-of-pocket funding.

If paying for senior care is a concern for you, let us know when you schedule your consultations or in-home assessments. We’re happy to help you evaluate and wade through your options.

Here are some of the agencies, organizations, and funding options that can help.

Medicaid

Medicare rarely covers the costs for more than one- or two hours of regular home care services (feeding, bathing, toileting, meal prep, etc.) per day. Medicaid will cover up to eight hours per day, depending on the situation and diagnosis. However, the scenarios in which they provide this coverage are specific, and the approval process is complicated and lengthy.

That’s not to discourage you if you feel your senior loved one qualifies. Rather, it’s important to note that you’ll need to cover the costs of care some other way until your reimbursement and regular payments come through.

Visit the Medicaid Home Page to get started, or speak directly to a Medicare representative by calling their toll free number, 877-267-2323.

Veterans Administration

The Georgia Veterans Administration (VA) often subsidizes or completely compensates home care costs. Qualifying veterans and their families can take advantage of these benefits by applying online or at their local VA office.

Once approval is submitted, Georgetown Home Care submits the required documentation to the VA and receives payment from their offices.

Read more on the Veterans Administration website, and then let prospective home care agencies know you’ll be using VA funds to learn about how that process works.

Home Care Loans (Eldercare Bridge Loans)

Medicare, Medicaid, and/or VA compensation can take a while to kick in. In the meantime, you’re responsible for caregiving costs.

Eldercare Bridge Loans are an option while waiting for benefits to commence. Read more about bridge loans for eldercare.

Getting Paid To Take Care Of Elderly Relatives

Sometimes, family members qualify for financial assistance programs as paid caregivers through the Social Security Administration.

While these funds specifically compensate the family caregiver, qualifying households may find that financial support increases the overall household budget, allowing you to bring in extra support for respite care or to help with homecare tasks throughout the week.

Read, Getting Paid to Take Care of Elderly Parents, to learn more.

Private Insurance

Private insurance companies know the cost of home care from a licensed caregiving agency is more cost-effective than assisted living and nursing home facilities. As a result, health insurance carriers often subsidize a portion of home care services to keep their clients healthier, happier, more independent, and out of facility-based care.

Contact your health insurance carrier to learn more about whether or not they cover all or a portion of the services required to keep your elderly loved one at home.

Long-Term Care Insurance & Life Insurance Conversions

Sometimes, our clients’ families are surprised to learn that their parents have existing long-term care insurance plans they never mentioned to their children. Similarly, they may hold existing life insurance policies that qualify for various types of conversions.

Long-term care insurance is designed especially to cover the costs of senior care, and that often includes home care services rather than residential facility care.

If your parent(s) has an existing life insurance policy, read the fine print carefully or give them a call. Conversion options include ceasing the monthly premium payments and receiving immediate payouts that can be used to offset the costs of care.

Reverse Mortgages & Home Equity Lines of Credit (HELOC)

Never move forward with a reverse mortgage or HELOC without meeting with a financial advisor or trusted legal professional. However, both of these options are helpful when a home is owned outright, or with minimal payments remaining, and/or during a strong real estate market.

The money pulled out via a reverse mortgage or HELOC is used to cover long-term care costs and is then repaid to the bank when the home is sold down the road, or when HELOC repayments are complete.

Understanding Your Options When Paying For Senior Care

Deciding how to pay for care for your elderly loved one doesn’t have to be complicated if you understand the options available to you.

Georgetown Home Care is happy to help you navigate your options when deciding on the best form of home care.

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