If you’re wondering how to pay for health care or other services you receive in your home, we’re ready to help answer those questions.
As part of a large network of care, the Good Samaritan Society understands how to navigate the health care world and has many resources and tools to utilize.
You can rely on us to help you coordinate eligibility with your physician and determine which payment options will cover the services and care you need in your home.
There are six ways you can pay for home health care, including:
1. Long-term care insurance
Long-term care insurance policies are specifically for helping you pay for services that you’ll need over a long period of time.
Unlike Medicare or private insurance policies, long-term care insurance policies may cover things like home health care, assisted living and nursing home care.
Local organizations may be able to help you find resources and assistance with the care you need, such as Eldercare Locator.
2. Medicaid
Medicaid is a federal- and state-funded program that helps people with very limited income and resources pay for health and medical expenses.
Coverage and eligibility for Medicaid varies from state to state.
Most Medicaid programs will help you pay for doctor visits, health equipment, prescriptions, lab and x-ray services, and inpatient and outpatient services from a hospital or care center.
Unlike Medicare, Medicaid may also cover long-term care services like nursing home stays, assisted living services and in-home personal care if you qualify for your state’s Medicaid program.
3. Medicare
Many seniors are enrolled in Medicare, the federal government’s health insurance program.
The basic coverage — Medicare Part A and Medicare Part B — can help you pay for hospital stays, doctor visits and care and equipment that are medically necessary.
To receive Medicare coverage for health care services in your home, the following conditions must be met:
- You’re enrolled in Medicare
- You’re seeing a doctor for the condition that requires home care services
- Your doctor says you need intermittent skilled nursing care, physical therapy, speech therapy or occupational therapy because of an illness or injury
- You’ve seen a physician within the last 90 days or within 30 days of the start of home health care services, or you’ve been seen in an acute or post-acute setting by a physician who has admitting and treating privileges in that location
- Your physician certifies that you are homebound, meaning you cannot leave your home due to your injury or illness, or that leaving your home is a taxing effort that requires assistance
If these criteria are met, Medicare may cover intermittent or part-time care. Generally, the care must be provided fewer than seven days a week, or fewer than eight hours a day. If requested by your doctor, Medicare may cover some exceptions for additional care.
Additional homebound information:
If you’re able to drive, you probably don’t meet the homebound requirement.
To be considered homebound, leaving your home must take a considerable effort and require assistance.
If you’ve been classified as homebound, it doesn’t mean you can never leave the house. You won’t lose your Medicare homebound classification if you only leave for infrequent, short periods of time to:
- Attend religious services
- Go to a licensed, certified or accredited adult day services program
- Receive medical treatments
- Attend special events such as family reunions, funerals, graduations or weddings
Typically, Medicare does not cover routine home care services such as daily assistance with medication, meal preparation and personal care like bathing and grooming.
4. Private health insurance
A private health insurance policy typically covers preventive care and deductibles toward things like prescriptions, specialized doctor visits and elective procedures.
Your individual health insurance may cover after-hospital recovery, skilled nursing care or in-home services, but usually only on a temporary and short-term basis.
In-home non-medical services are covered by many private health insurance plans,
Contact your health insurance provider to clarify what your policy covers.
5. Private pay
Private pay, also called self-pay, means you use your own resources and finances to pay for the care you receive.
Any services, housing or care you choose can be paid for by private pay.
Talk to your financial advisor, attorney or social worker to see if this is the best option for you.
6. Veterans Affairs benefits
If you’re a veteran who served active military duty, you may be eligible to receive health care benefits from the U.S. Department of Veterans Affairs.
Your eligibility and coverage may vary, but VA benefits typically cover preventive care, inpatient care, specialty care and emergency care.
In some cases, veterans’ benefits, will cover in-home non-medical care.
Do you have more questions about services and how to pay for them?
