Understanding Who Pays for Home Care: Exploring Your Options

Signs Your Loved One May Need Home Care

Your mom has lived safely and independently in her home for almost 50 years, but you’re now seeing signs that she may need help – she’s not styling her hair, there’s spoiled food in the fridge and unpaid bills on the counter. 

Is it time to move her to an assisted living community?

“It’s not unusual for families to think that’s their only option – but it’s not,” said Sierra Goetz, co-founder and operations director at HomeCare Advocacy Network (HCAN). Professional in-home caregivers can often provide seniors with the help they need to continue living in their home.”

Understanding Home Care Payment Options

While organizations, like HCAN, have been offering professional care for decades, many families are still unclear about who pays for home care services. The most common home care payment options are:

1. Private Pay: Using Personal Funds

Most families use personal funds to pay for home care, making it the most straightforward way to cover senior home care services. For example, they tap into retirement income, personal savings, stock income, or proceeds from selling a home. This option allows families to:

• Customize the level of care needed, ranging from a few hours per week to full-time support.
• Maintain control over care decisions without insurance restrictions.
• Avoid waiting periods or eligibility requirements.

By choosing private pay, families can ensure that their loved ones receive the specific care they need while enjoying the flexibility and autonomy that comes with it.

2. Long-Term Care Insurance: What You Need to Know

Policies vary, but seniors typically become eligible for benefits when they need assistance with day-to-day tasks in order to live independently. If your loved one has a long-term care insurance (LTC) policy, it may cover some or all of their senior home care services. These policies are designed to assist with personal care, companion care, and specialized care services that help seniors remain independent at home.

3. Medicaid: Coverage for Low-Income Seniors

For low-income seniors, Medicaid Waiver may cover some medical and non-medical home care services. Your state Medicaid program may cover home care services for eligible seniors in your area. This program helps seniors receive personal care, companion care, and respite services to avoid nursing home placement.

Eligibility Requirements Include:

• Seniors who meet Medicaid’s financial eligibility requirements
• Individuals who require assistance with activities of daily living (ADLs)
• Seniors who prefer to receive care at home rather than in a facility

4. Medicare: Limited Coverage for Home Care Services

While Medicare does not cover long-term home care services, it will typically provide coverage if the senior is receiving medical services and needs help with activities of daily living as part of a doctor’s care plan. For example, non-medical services might include assistance with bathing, dressing and toileting. 

5. Veterans Programs: Support for Qualified Veterans

The U.S. Department of Veterans Affairs offers several programs to help qualified veterans and their spouses pay for in-home care. Veterans and surviving spouses may qualify for financial assistance through the VA Aid and Attendance benefit or other VA Home and Community Based Services, which helps cover the cost of in-home senior care.

Eligibility Requirements Include:

• Being a wartime veteran (or spouse) with an honorable discharge
• Requiring assistance with daily living activities such as bathing, dressing, and mobility
• Meeting specific financial and medical qualifications

This benefit can significantly ease the financial burden of home care, allowing veterans to receive the support they need while remaining in the comfort of their own homes.

The Importance of Personalized Care Plans

“Many families aren’t aware of the different ways to pay for home care,” Goetz said. “Our care team works closely with seniors and their families to develop personalized care plans that meet their unique needs and budget.”

Resources for Home Care Services

Navigating home care payment options can be overwhelming, but you don’t have to do it alone. Our knowledgeable team is here to answer your questions, verify benefits, and help you find the best financial solution for your loved one’s care.

For more information about services that could help your aging loved ones live safely in their homes for as long as possible, visit hcan.com or contact your local HCAN-supported office.