What Insurance Covers In-Home Care?

As you age, you become more susceptible to illnesses and injuries. Should this happen, it’s natural to want to stay and recover in the comfort of your home. However, sometimes you might need assistance to make that possible. In-home care services provide this support, offering everything from light housekeeping to skilled nursing care.

About 70 percent of Americans are comfortable with in-home care and see it as an option. But while these services can bring peace of mind, they come with a cost. So, you may wonder: what insurance covers in-home care? Here are some common options and how to decide whether coverage may be right for you.

Medicare

Medicare may cover some in-home care costs but enforces strict rules. For instance, you must be considered homebound (leaving home is difficult due to your health) and receive care from a Medicare-certified home health agency.

Additionally, coverage is usually short term. Medicare typically doesn’t cover long-term help with daily living activities like dressing, eating, or bathing.

Medicaid

Medicaid is a joint federal and state-run health insurance program for people with low incomes and few assets. Unlike Medicare, which is primarily available to those 65 and above, Medicaid covers people of any age who experience financial challenges.

This program can pay for more comprehensive in-home care than Medicare, sometimes including help with daily living activities. However, Medicaid eligibility rules and the specific services covered vary by state, and income or asset limits may apply.

Long-Term Care Insurance

Long-term care insurance is designed to help with in-home care, assisted living, and nursing home costs. It can also help cover ongoing care needs, like bathing and dressing.

If you’re considering this type of policy, you must purchase coverage before you need care. In addition, premiums can be higher, especially as you get older. So, carefully compare policies to find the right level of coverage for your needs.

Supplemental Insurance Policies

Supplemental insurance policies can help fill the gap between Medicare’s coverage and what you may need. Medigap is a supplemental policy that works alongside Medicare Parts A and B. You purchase this plan through a private insurance company.

However, like Medicare, Medigap isn’t designed to pay for long-term care. While you may see more coverage for in-home services, requirements may be limited to medically necessary care over the short term. A Medigap plan may not reduce the out-of-pocket costs for needs outside these services.

Other Potential Sources of Funding

Depending on your situation, you may have other options to help you pay for in-home care costs. For example, if you or a loved one is a veteran, you can explore benefits programs through the Department of Veterans Affairs. These programs sometimes cover in-home care costs.

Additionally, some life insurance policies offer optional riders that provide funds for long-term care, including in-home services. Review your policy to see if this add-on is available, and consider how it may increase your premium.

Finally, check your area for local community-based programs or nonprofit organizations that offer assistance or subsidies for in-home care. The National Council on Aging provides resources.

Evaluating Your Insurance Needs

Deciding whether you need additional coverage for in-home care depends on several factors.

Your Age and Health

The likelihood of needing in-home care increases with age. Consider your or your loved ones’ health and whether certain health conditions in your family may lead to future care needs.

Support System

A strong support system, such as loved ones close by who are willing to help, may reduce the need for paid in-home care.

Current Policy Limitations

Most insurance policies, even long-term care plans, restrict what in-home care services they cover and for how long.

Start the Planning Process Now

The earlier you begin planning for potential in-home care, the better your chances of finding coverage options that meet your needs. Don’t hesitate to ask your provider what insurance covers in-home care and review the available options. For personalized guidance on finding the right mix of financial and care solutions, consider speaking with a financial professional specializing in elder care.

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