Paying for in-home care

A critical step in finding the right home care for a loved one is knowing your options for paying for services. With different service providers accepting different payment methods and different payment sources covering different services, this important step in the process can be challenging. This basic introduction can help you get started, ask the right questions, and make the right decision. Contact your local WTS Healthcare office to learn even more about different solutions so your loved one can receive the best care.

No matter what home care service provider you call, you’ll want to go into the conversation armed with information about your loved one’s financial situation. Here are some questions to help you prepare:

• What income, savings, and assets are available?
• Did your loved one or their spouse serve in the military?
• Do they have long term care insurance? Whose the provider? What does it cover?
• What health insurance do they have? What does it cover?

Six common ways to pay for home care services are private pay or “out of pocket” (cash, check, credit, or trust), long-term care insurance, private health insurance, VA benefits, Medicaid, and Medicare. Except for private pay, each of these payment sources has unique eligibility requirements and service limitations. In many cases, the right care solution for your loved one may require a combination of these payment sources. Your local WTS Healthcare office can help you identify which of these options or combination of options is right for you.

Paying with personal funds gives you and your loved one the most flexibility when seeking care services. You can work with your loved one’s doctors and a local home care provider like WTS to tailor a care plan specifically to your loved one’s needs — from meal prep, companionship, and light housekeeping, to bathing, grooming, and feeding, to infusions, wound care, and medical equipment set-up.

Private pay helps cover additional care services that can supplement the limited services and support covered by other sources like Medicaid or Medicare as well as the “elimination period” before long-term care policy begins to pay benefits.

Long term care benefits can pay for in-home assistance with Activities of Daily Living such as bathing, dressing, incontinence care, toileting, eating and assistance with transfers in addition to things like meal prep, light housekeeping, transportation, medication reminders & more, in the comfort of their own home.

WTS helps our clients understand and process their Long Term Care Insurance (LTCi) claim. We may bill your LTCi directly. In order to bill the insurance, clients complete a simple “Assignment of Benefit” or “Direction to Pay” form.  When we bill insurance on your behalf, we save you the effort of sending in documentation of care provided and waiting 30+ days to get reimbursed by the insurance.

Thanks to partnerships with national insurance companies, WTS offices are credentialed in-network with insurance companies across the country. Many WTS offices also are in-network with local insurance companies. Call to learn more.

The Veterans Aide & Attendance Pension provides qualified veterans and surviving spouses, a pension that can help pay for at-home assistance with daily living activities such as bathing, dressing, transferring, toileting, light housekeeping, transportation, meal preparation and more.

A veteran or the surviving spouse of a vet (and were still married at the time of death) who has served at least 90 days or more on active duty, with one day beginning or ending during a period of war, in need of assistance at home due to their disabilities may be eligible for the VA’s non-service connected disability pension (up to $2020 per month in supplemental pension depending on their situation). Note: this is not a benefit for a person needing housekeeping or respite part time care.

Medicaid can pay for doctor appointments, hospital expenses, medicine, therapy, some adaptive equipment, and additional services. The state writes a plan that tells what kind of services will be provided under their Medicaid Waiver program. Each state’s plan is different, so consult Medicaid.gov to learn more about your state’s requirements and coverage.

You may qualify for help from a Medicaid home and community-based service (HCBS) waiver program if you:

• meet your state’s level-of-care or functional eligibility requirements for home and community-based services; and
• have income and assets below certain guidelines.

Medicare Home Health Agencies provide service based on a doctor’s prescription. Home Health services also are based on a specific condition, and are usually only provided for a set period of time. Typically, Medicare can cover just a few personal care visits, but no companion care or supportive care services. Medicare agencies are limited in what they can do and for how long, so if you’re looking for additional support, call us. NOTE: WTS does accept Medicare, based on a limited amount  of treatment. we can partner with you and your Medicare Home Health Agency to provide additional care needed for any amount of time.

Home care can seem expensive and not all home care service providers are the same. When interviewing home care agencies and assessing the value, range, and quality of their services, here are a few important questions to ask:

• Do you provide insurance for accidents, if they occur, in the home?
• Do you require a minimum number of hours for service?
• Are you licensed for medical care and non-medical care?
• Do you have an RN to conduct an initial assessment before starting each engagement and to follow up with supervisory visits to ensure the plan of care is being carried out to my satisfaction?
• Are your caregivers trained and competency tested?
• Are all employees drug tested, background checked, licensed, bonded and insured?