Senior Care Blog

How to Pay for Home Care: Part One

By Jonathan Marsh, Owner

How to Pay For Home Care - Florida Home Care Guide

Recently, the Home Helpers of Bradenton has shared excerpts from its “Florida Home Care Guide,” to better explain what home care is and how to find an appropriate provider for your needs. We’ll use a two-part article to explain how to pay for home care, again excerpting from our “Florida Home Care Guide.”

There are multiple sources to pay for home care. Home care providers will differ in terms of what sources of payment they can or will accept. Payment sources for home care can be categorized into two broad categories: 1) private pay and 2) federal, state, and county programs.

Medicare May Pay for Home Care When Receiving Skilled Care

To help you understand what Medicare will pay for, the terms “skilled care” and “unskilled care” are important to know to avoid confusion of terminology.

It is a common misconception that Medicare will pay for ALL home care (unskilled care) needs. However, home care (unskilled care) may only be paid for by Medicare if home health care (skilled care) is currently being received.

In general, Medicare will pay for services in the home when a doctor certifies that home health care (skilled care) is required. The payment for services is done by lump sum to a Medicare-certified home health home agency for covered services in a 60-day period. This period is known as the “episode of care”. The lump sum must cover all services (both skilled and unskilled) rendered during the episode of care. Even though some home care (unskilled care) may be included as part of those services being received, those unskilled services may be limited (if at all) as they reduce the portion of the lump sum that can be used to cover the home health services (skilled care). If a portion of the lump sum is used for home care (unskilled care) to assist with activities of daily living such as bathing, feeding, transferring, etc., these home care visits will be intermittent and for short durations.

For more information on Medicare and what services are covered in the home, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227). A great resource is their official government booklet ‘Medicare & Home Health Care’, which explains eligibility and what is and is not covered. That booklet is found at the following URL:
https://www.medicare.gov/Pubs/pdf/10969-Medicare-and-Home-Health-Care.pdf

Private Pay Options

SAVINGS

Many home care clients opt to pay for home care using their savings. Savings may be in the form of cash on hand, bank accounts, retirement accounts, etc.

LONG-TERM CARE INSURANCE

Some individuals have planned for long-term care expenses with a long-term care (LTC) insurance policy. LTC insurance policies allow for coverage of the unpredictable cost of long-term care in the future. LTC insurance policies may have been purchased individually or provided through an employer or other organization or program. Premiums are paid over time. An individual that has an LTC plan will qualify for benefits generally when they need help with two to three activities of daily living. Be aware of what is called an elimination period during which the individual may have to pay for a certain amount of days or hours of care before benefits are received from the LTC insurance policy.

OTHER OPTIONS

Additional options that can be considered from a private-pay perspective are reverse mortgages, home equity lines of credit, life insurance policy conversions, or loans designed specifically for home care. Before proceeding with these options, you may wish to seek the guidance of a financial advisor.

Next month, learn more about county, state, federal, and VA programs to help cover the cost of home care.

To learn more about the different kinds of home care providers, you can download the “Florida Home Care Guide” for free at the following link: Florida Home Care Guide.

Call Home Helpers of Bradenton to Care for Your Loved One

Need better care for your senior loved one? Give Home Helpers of Bradenton a call. We provide companion care, personal care, homemakers services, and Alzheimer’s and dementia care so family members can rest easier. We help families in Manatee County in and around the communities of Anna Maria, Bradenton, Bradenton Beach, Ellenton, Holmes Beach, Lakewood Ranch, Longboat Key, Myakka City, Palmetto, Parrish, and Sarasota. Call us at 941-999-1960, or visit us online at http://www.homehelpershomecare.com/bradenton/home.