Does Health Insurance Cover In-Home Health Care?

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Choosing Excellent Home Health Care As someone who is fiercely independent, I never imagined myself living in an assisted living facility. For that reason, when I was diagnosed with a serious condition, my doctor recommended home health care. It was a little bit intimidating for me at first, but before I knew it, I was living at home, receiving the care I needed from the comfort of my own bed, and getting stronger each and every day. I had such a powerfully positive experience with home health care that I started this very blog. Read more about how home health care could help you or your family members.

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One of the most common questions about in-home care is whether health insurance (e.g. private insurance or Medicare) will pay for the service. It depends on the type of care that's being provided, whether it was ordered by the doctor, and the individual's insurance policy. Here's how you can tell whether in-home care is covered and how to pay for it if it's not.

Home Health Care vs. Personal Care

There are two types of in-home care available: home health care and personal care. Home health care involves care provided by licensed medical professionals, such as nurses, physical therapists, and even occupational therapists. These are services typically ordered by a doctor or specialist to address health issues the patient may be struggling to overcome.

Personal care, on the other hand, can be thought of as lifestyle assistance. Professionals in this group help patients care for themselves and their homes, which may involve grooming, meal preparation, light housework, and companionship. Personal care providers are typically hired by the patient or the person's family.

Home health services are generally covered by health insurance, but personal care services are not. Personal care services are generally not medically necessary like home health services typically are, so personal care is typically not eligible for coverage.

Paying for In-Home Care

There are a couple of ways to pay for in-home care if it's not covered by health insurance. Some long-term care insurance policies will cover both home health and personal care, so the care provider would either submit invoices directly to the insurance company or you would have to file a claim for reimbursement.

If the person requires in-home care over a long period of time, another option is to take out a reverse mortgage to pay the expenses. A reverse mortgage is essentially a home equity loan, but it doesn't have to be repaid until the last surviving homeowner permanently leaves the home or dies. The proceeds from this loan can provide a source of income as well as be used to pay healthcare expenses, so it may be worth talking to a lender about this option.

Low-income people may qualify for coverage through Medicaid. However, this insurance company will typically only pay for home health care and not personal care. Using Medicaid to pay for other healthcare expenses, though, may free up money that could be used to pay for personal care.

There may be other options available for paying for in-home care services. Contact an in-home care service, such as Neighbors Home Care Services, for suggestion or assistance with this issue.

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