Paying Senior Home Care Costs Through Insurance

When considering whether to hire an in-home caregiver, one of the first things you may ask is how you will pay for home care costs.

Medicare and private health insurance plans do not cover in-home personal care services. You may qualify for coverage through your state’s Medicaid program. Eligibility criteria and benefits vary by state, but you may only qualify for it after you deplete most of your savings.

Long-term care insurance policies, on the other hand, can cover the care costs if you–or a loved one—develops a chronic medical condition, disability, or cognitive problem such as dementia.

How Do I Buy Long-Term Care Insurance?

Purchasing a long-term care insurance policy is similar to obtaining a life insurance policy. An insurance agent or company representative will ask you to complete an application and answer health questions. The insurance company will review your application and medical records and determine the cost of your coverage if you are approved.

Don’t wait too long to purchase a long-term care insurance policy. Most insurers won’t issue policies for people over 75 or who are living with a debilitating condition. Most people purchase long-term care insurance in their 50s and early 60s to protect their savings and ensure they can receive quality senior care if needed.

Generally, younger people in good health pay lower premiums. However, it’s important to remember each policy provides different coverage limits, benefits, and options with different price tags.

How Does Long-Term Care Insurance Work?

While each insurance policy is different, most will be “triggered” if you can’t perform two or more activities of daily living, such as bathing, toileting, dressing, eating, or transferring—or if you develop cognitive impairment.

If you (or a loved one) meet the triggering criteria and need care, you will need to file a claim with your insurance company, which may ask for medical documentation and a copy of your care plan. An insurance company representative may also send a nurse to evaluate your condition.

Most long-term care insurance policies require you to pay for your care out-of-pocket for a period of time — usually 30, 60, or 90 days — before the insurance benefits kick in and will have a daily benefit limit and a lifetime-maximum benefit.

Many long-term care insurance policies will reimburse a daily dollar amount to pay for services to assist with activities of daily living. However, your individual policy will determine:

• Amount paid out
• How the benefit is paid
• How long the benefits last

Can Long-Term Care Insurance Pay for a Visiting Angels’ Caregiver?

Yes, depending on your individual policy, you may be able to use long-term care insurance to pay for Visiting Angels’ in-home personal care.

Long-term care insurance is a tool that can finance in-home personal care services, but you should understand what your policy covers and how to file a claim.

A Visiting Angels care coordinator can provide you with a copy of a care plan, which may be required by the insurance company as proof of services provided. Visiting Angels’ care coordinators may be able to assist you with filing a claim, but some insurance companies may require you to complete and submit claim forms yourself.

Reach out to your nearest Visiting Angels office. Visiting Angels’ care coordinators are familiar with long-term care insurance and will meet with you to discuss your insurance situation during a free home care consultation.