Medicare and Medicaid

Many people are under the false impression that Medicare, Medicaid or their health insurance will pay for home care costs.

Medicare was developed for short term acute care in the hospital. It also pays for non-medical home care services after a hospital stay (subject to eligibility requirements) for a limited time period, but only if there is also a need for skilled nursing, physical, speech or occupational therapy. Failure to meet these requirements means that must pay for home care out of pocket.

Medicaid is an assistance program jointly financed by federal and state governments for lower income people. Using broad federal guidelines, states design their own programs (in Massachusetts it’s MassHealth).   See the “State Resources” tab for more information on Medicaid programs in Massachusetts.

Commercial Health Insurance Companies

Commercial health insurance policies generally cover some home care services for acute needs, but benefits for long-term services vary from plan to plan. Commercial insurers, including Blue Cross and Blue Shield and others, generally pay for skilled professional home care services with a cost-sharing provision. Such policies occasionally cover personal care services.

Long Term Care Insurance

Increasingly people are relying upon long term care insurance policies to finance their home care or facility care.  Most policies in force have separate limits for facility care and home care, but even policies issued in the early 1980’s offer home care benefits.  North River Home Care accepts long term care insurance.

Reverse Mortgages

Reverse Mortgages are increasingly being used, and worth exploring for many seniors.  Generally, these allow up to 50% of the house value to be borrowed with repayment deferred until the house is sold.  It’s effectively a way to take equity out of a home without having to make monthly payments.

Veterans Benefits

There is a benefit known as the Aid and Attendance Benefit available to Veterans and their spouses.  There are income and asset limitations.  Please see the “Veteran’s Benefits” tab for more information.

Financing In Home Care in Boston

As with all legal and financial matters, its best to seek the advice of a professional.  If you would like to be referred to an elder law attorney, long term care insurance provider or reverse mortgage specialist we can certainly help. Give us a call at 781-659-1366.