As I said before and in my prior posts (and throughout our website)

…not all home care is covered by medical insurers. This comes as the single biggest SHOCK to people we talk to. 

I understand why people are shocked. It makes no sense that so much NECESSARY care wouldn’t be covered by medical insurance. While I think that may change as the Boomer wave crests, the truth is that

Whaddya mean you don’t take Medicare? Or Blue Cross? Or AETNA? Or….insert medical insurer name here. 

When we explain that these payers don’t cover personal home care, companionship, safety supervision, etc., they are flabbergasted and I don’t blame them. I was as well. Personal Home Care is a real MEDICAL need. Fall prevention is extremely important. But for the time being, Personal Home Care that helps people with mobility and memory care needs in the home is NOT covered by medical insurance. Just think of it this way…if the thing the senior needs help with is chronic and won’t improve, medical insurers don’t cover it. There are some very, very rare exceptions. Or they may cover it WHILE the senior is also receiving medical care. But once medical care is no longer being provided, paying for Personal Home Care becomes the responsibility of the senior and his or her family member. 

In a separate post we discuss the costs of various kinds of services but since personal and homemaker and companion care is most often paid for out of pocket by families, that is the care you’ll want to know the cost of first. Generally it ranges from $18 (companion only) to $25 per hour. And don’t expect that to go down, as the cost to pay a caregiver goes up (because we’ve decided to pay them the same thing we pay vet techs finally), the cost of this care is going up. So when you’re planning, think more along the $25/hr end of the spectrum if you want quality care. 

There’s a great cost calculator found on the federal long term care insurance website.  It allows you to select your state and the number of hours of care the senior needs to produce a quote for what the annual cost is likely to be.

In Florida, where we provide care, the cost for 8 hours of care 5 days a week, will run you roughly $36,000 per year.  

If that has you freaking out, I’m glad. It’s time someone got all of our attention. This is a huge cost that most families have not planned for because they thought someone else (insurance) was going to pay for it. Unfortunately that’s not the case. If you don’t have long term care insurance, don’t qualify for veteran’s aid and attendance, or don’t qualify for – or want to spend down your assets to qualify for – Medicaid, then you’d better start thinking about how you’re going to find these funds. And a facility is not less expensive, by the way. Independent living can be, but no one in independent living needs 8 hours of care a day. The closest equivalent would be assisted living and most ALFs cost $5000 a month and up.

Now that you understand that payers will vary based on the services needed, let’s examine each one more closely in our next posts.

  • Who pays for Personal Home Care – Private Pay, Long Term Care Insurance, VA Aid & Attendance, Medicaid
  • Who pays for Home Health – Medicare, Medicare Advantage, Insurers, VA, Medicaid (check on this before you write it)
  • Who pays for Hospice – Medicare, Medicaid, Medicare Advantage, Insurers
  • Navigating your Benefits