Cost of Home Care Services

Many older folks don’t need the high level of care provided by an assisted living facility or a nursing care home.

Most of our clients only need a minimal amount of help with certain activities a few times each week.  Short visits by a home care aide provide them with this minimal level of assistance, keeping costs low compared to the cost of staying in an institutional facility.  The best part about care provided in the home is that our clients are able to “age in place”; maintaining their independence and continue living in their own home.

How will you pay for home care services?

blue glow heart for website SPOT 2Private Pay

Home care services that fail to meet the criteria of third-party payers (such as insurance) must be paid for “out of pocket” by the individual, their family or other party.  The cost of services is based on the level of care the client requires and is determined at the time of the initial assessment.

Once the services have been agreed between client/client representative and Hearts of Gold Caregivers, a two-week refundable deposit will be required to initiate services.  This refundable deposit will be applied to any outstanding bills at the conclusion of services.  Any remaining amount will be reimbursed promptly.

Clients will receive invoices for services in the mail twice a month (or weekly for 24-hour care).

blue glow heart for website SPOT 2Insurance

Health Insurance policies typically do not cover the cost of home care services.  Policies can vary, however, and some may cover for acute needs that may include home care services.  Benefits vary by company, and  in some cases they can vary from policy to policy within the same company.  Check with your insurer to see what may be covered in your policy and whether you can use this benefit.  When you know what your coverage is, contact Hearts of Gold Caregivers for a free consultation.

Long-Term Care Insurance will, in most cases cover costs of in home care.  Years ago, Long Term Care Insurance was anticipated to be used for assisted living or nursing home services, so it is sometimes referred to as “Nursing Home Insurance.”  Now, with the prevalence of home care services, Long Term Care Insurance companies have included home care services under the umbrella of the types of care that are covered.

Depending upon your policy, it may or may not have an “elimination period,” meaning there may be a period of time that you would have to pay for services out of pocket before the insurance kicks in.  In some cases it may be 30 days, 60 days, 90 days, or more.  These are not normally calendar days, but the actual number of days that a caregiver is working for you.

There’s usually a daily maximum amount that the insurance company will pay out.  This may have changed over time if you have held a policy for a number of years.  So what is written on your original policy document may have changed.

Benefit payments are often dependent upon the care that is provided.  Typically, assistance with certain Acts of Daily Living (ADLs) is required for benefits to be paid.  These details can be explained to you in more depth when we visit you for a free home care consultation.

Under normal circumstances the client/client representative selects a home care agency they would like to work with and the Insurance Company reimburses the policy holder for approved services.

blue glow heart for website SPOT 2Veterans Administration

The Veteran’s Aid and Attendance (A&A) Pension provides benefits for veterans of certain specific war periods and their surviving spouses who require regular assistance with Acts of Daily Living  (ADLs) such as eating, bathing, dressing/undressing and toileting.  Your physician or practitioner will need to certify that you require this assistance to qualify for A&A benefits.

Official application forms must be submitted to initiate the process (Form 21-526 Veteran) (Form 21-534 surviving spouse).  Benefits are awarded based on need as well as available income to cover costs of care, so not every application for A&A benefits will be successful.

For individuals who are successful, A&A Pension can provide up to $1,632 per month to a veteran, $1,055 per month to a surviving spouse, or $1,949 per month to a couple.  The application process can be slow so it’s a good idea to start the paperwork now if you think you may be eligible.

Contact the Veterans Service Officer nearest you:

Hood River County (Tuesdays & Wednesdays 8:30-4:30)              
Address: 601 State Street, Hood River
Phone: 541-386-1080
 
Wasco County (Monday – Friday 9:00 – 5:00)
Address: 201 Federal Street, The Dalles
Phone: 541-506-2502
 
Multnomah County (Monday – Friday 8:00 – 4:30)
Address:  421 SW Oak St. Portland, OR 97204
Email: [email protected]
Phone:  (503) 988-VETS 
 
You may hear about individuals and agencies prepared to help you with the application process.  WARNING – many of these are scams, so be careful!  Never pay any money up front when applying for this benefit.

blue glow heart for website SPOT 2Medicare or Medicaid

Medicare pays for some Home Health services, but does not pay for home care services.

Medicaid is a joint federal and State assistance program for low-income individuals.  In some cases, it will provide funds toward the cost of home care.  At this time, Hearts of Gold Caregiver is not a Medicaid-eligible agency but this is due to change in the first months of 2015.