At A Caring Choice, Inc. we get many calls that include the question “Are your services covered by Medicare?” The following is a brief overview of Medicare, Medicaid, and paying for non-medical “in-home” care services. There may be other ways to pay for in-home care, however, the most common are listed.
Medicare is a federal health insurance program for approximately 45 million elderly and disabled. It is run entirely by the federal government. It provides some payment for hospital stays, rehabilitation, skilled care, drugs, and limited non-medical.
Medicaid provides health care to 56 million poor Americans. The federal government sets broad rules and pays 57% of the expenses while states run the program and pay 43% of the expenses.
There are a few ways to pay for non-medical (non-skilled) care.
- Medicare covers a limited amount when the patient has doctor ordered skilled care. It is up to the doctor to determine what non-medical services are essential while the patient’s health is improving. These non-medical services must be provided by a Medicare certified company and usually accompany the provided skilled care.
- The Council on Aging (COA) has 2 programs that pay for all or portions of services. Passport is a program funded by Medicaid and ESP is a program funded by a voter approved tax levy. Services are provided by companies that are contracted by the COA.
- The Veteran’s Administration has programs for veterans and their spouses. Services that are covered can include: non-medical in-home care, hospice, respite, assisted living, geriatric assessments, and nursing home stays.
- Long Term Care Insurance policies often include provisions for covering portions of care. Each policy must be evaluated to determine the provided coverage
- Private Pay – Out of Pocket
Submitted by Jim Kummer – President at A Caring Choice, Inc.
Call Jim at (513) 574-4148 for more information on paying for medical or non-medical home care.