Is a Home Health Aide Covered By Insurance?

It’s very true – there’s no place like home. That’s why the elderly strive to stay there for as long as they can. When a person is aging or recovering from a recent surgery and needs help with their activities of daily living, a certified home health aide may be necessary. But is a home health aide covered by insurance? There are many different types of insurance with different coverage for home health aide services.

Private Health Insurance
InsuranceEvery private health insurance company is different but many will pay for certain home health care services. Services usually need to be medically necessary and sometimes a private health insurance provider will require a pre-approval for a home health aide.

Medicare
Medicare Insurance has strict rules for home health aides. They will cover intermittent skilled nursing care, in-home physical or speech therapy, occupational therapy and more. These services must be under the management of a doctor and must be reviewed regularly by him or her. Medicare does not cover 24-hour in-home care or homemaker services.

Medicaid
Medicaid coverage can vary state by state. The New York Medicaid program does cover in-home care services for personal care assistants and certified home health aides. However, to be eligible for these services, it must be medically necessary. There is also a stipulation that the person receiving the care should be in stable condition. This means that they are not expected to undergo sudden deterioration or improvement. The coverage is meant for those needing long-term in-home care.

Long-Term Care Insurance
Long-term care insurance is private pay insurance that can assist in reimbursement for home care costs if an individual meets the eligibility criteria in the policy. This insurance covers care not covered by private health insurance, Medicare or Medicaid and protects your savings accounts from becoming depleted by the steep cost of long term home care. The insurance must be purchased while the patient is fit, that is, before long term care becomes necessary.

Getting the right in-home care is important. There are many different insurance plans available and it is always prudent to check with your carrier regarding eligibility criteria, deductibles, and reimbursement. Contact your insurance representative, financial advisor, and friends about the choices available. You may also want to contact a home healthcare provider like David York Agency to ensure the policy you choose is compatible with the home care they provide.

David York Agency provides skilled home health aide services for elderly patients needing in-home care. David York Agency would be happy to assist you with your long-term care planning. Contact us at 718-376-7755. Please like us on Facebook or follow us on Twitter or LinkedIn and visit our website at http://davidyorkhomehealthcare.com/.