For seniors who qualify, Medicaid does pay for in-home care. In order to receive Medicaid coverage of in-home care, seniors must meet the requirements for both medical need and financial need. The senior will need to undergo a medical evaluation to prove that they need the level of care they are receiving.
While home health care that offers the same level of care as a nursing facility is a federally mandated benefit of Medicaid, personal care services are not. So while some states’ Medicaid may cover companion care and personal care assistance, others may only cover home health care. Additionally, the program which delivers assistance can vary. For example, in some states, home care is a benefit of standard Medicaid. In other states, residents in need of financial assistance for in-home care will need to access assistance via a Medicaid waiver program.
In-home Care personal Service Agency will assist you applying for Medicaid benefit and we will follow up with our clients.
These Home and Community-Based Waiver programs (HCBS waivers), also known as 1915(c) waivers, allow seniors to self-direct their care to best meet their needs. Often, this means that someone who requires a nursing home level of care can choose to instead receive in-home health care, and still have the cost covered by Medicaid. Note that while Medicaid is an entitlement benefit, waiver programs are not. Depending on a state’s program laws and budget, some people who qualify for the waiver program may still not receive the benefit or may be placed on a waitlist.
In some cases, an individual’s private long term insurance may cover some of the cost of in-home care. This typically applies to people with long-term care insurance, as most long-term care services, including home care, are not covered by regular insurance policies.
Long-term care insurance is designed to cover senior care, including in-home care. However, coverage varies depending on the insurance provider, the specific policy, and other factors, including the age of the beneficiary when they signed up for the policy. Often, long-term care insurance will only begin to cover care once the beneficiary needs assistance with at least two ADLs. So those only in need of companion care may not be covered even if they do have long-term care insurance.
Note that purchasing long-term care insurance once you already need care is typically not an option, and if it is, the policy will not cover very much.
Please call us if you are not sure about your long-term insurance coverage.
For those with the resources to do so, private pay is always an option. Our company is locally founded and our cost is very competitive with nationally franchised companies. Please call us for more information!