June 15, 2017
This month we are going to discuss financing options to stay in your home by hiring home care. In the blog about options to stay in the home, we briefly discussed this, but now we will go into more detail. If you haven’t read that yet, I would suggest reading that first.
So back to the information to help you finance staying in your home with home care. There are a variety of ways to pay for home care.
Private pay means you are hiring someone and you are paying them with your own funds. If someone has a long-term care insurance policy, I suggest you read through the policy and speak directly with a representative from that company. Every policy is different and it is important to know what your policy covers. If you are a Veteran or surviving spouse, you can call the Veteran’s Administration to see if you could qualify for some assistance with payments for care. If you aren’t sure where to turn, you can call me.
Medicare and Medicaid are a bit trickier. We are going to go through the details of each so you have a good understanding of what each covers. Medicare is the insurance you receive upon turning 65. Medicaid is for low-income seniors and you must go through an application process to be accepted.
Medicarewon’t pay for anyone coming to your home to provide services unless it is skilled nursing care. This means that Medicare is not paying for someone to clean your house or give you a bath. They are only paying for therapy services such as physical, speech, occupations; or nursing services such as wound care or IV therapy. In order for Medicare to pay for someone to come into your home, your doctor has to prescribe that you need this care and develop a plan of care for you (what someone would do while in your home). You also have to be considered homebound. This means that the doctor can’t have someone come to your house for physical therapy if you are able to drive down the road and get physical therapy at an outpatient clinic. The doctors’ assessment will be reviewed by Medicare, and that is what determines how much time per week that is covered. Most often, Medicare is going to pay for home care to come after a hospitalization until you are 100% recovered.
Medicaidis assistance you have to qualify for. There are some basic requirements that might help you determine whether this is something to talk to an expert about. To qualify for Medicaid, you must:
If you think you might qualify, our VOYCEconnect service can talk more with you about requirements. Medicaid will help pay for someone to come into your home. Basically, your doctor and Medicaid will do an assessment on how many hours and days per week are needed. Keep in mind, Medicaid is most likely not going to pay for someone to be with your daily. More commonly, 2-3 days a week for a half day.
There are two options if you qualify for Medicaid and would like to hire someone in the home. You can hire a professional from an agency that accepts Medicaid; or, if you are able to make decisions and direct your own care, you can choose Consumer Directed Care. This means that the person that needs care must be able to make their own decisions and be clear on their needs with the person they choose to care for them. This could be a family member, friend, or neighbor, but cannot be your spouse.
If your income is slightly over the allowable income for Medicaid, you may qualify for a spend-down. This means that your Medicaid benefits would not start until you used your extra income for medical needs.
Here is a chart to help summarize
.Obviously there are more details to Medicare and Medicaid, but I think these basics will help you determine what you should pursue.
Now everyone’s favorite part. Here is what youneed to do:
Disclaimer: This blog acts as an overview for you. Please do not hesitate to post questions here or reach out to me at VOYCE at 314-919-2403 or firstname.lastname@example.org. My focus is on the St. Louis region in Missouri.
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