Many people are surprised to learn that health or medical insurance does not cover in home care, even if such services are recommended by a doctor.
Long-term care insurance pays for home care services such as assistance with running errands, meal preparation, daily grooming and more. However, less than 10% of Americans have long-term care insurance policies. That’s surprising given that data shows almost 70% of Americans who reach the age of 65 will be unable to care for themselves at some point without assistance. Furthermore, the majority of people surveyed say that they want to “age in place,” or continue living in their homes rather than go to an assisted living facility or nursing home.
Not only are some people confused about what insurance will cover home care, there can also be confusion over what home care is. Home care is most often mistaken for home health care.
Home health care is considered medically necessary and prescribed by a doctor. This care is delivered by a medical professional such as a physical therapist, social worker, occupational therapist, or registered nurse. These specialists may dress wounds, administer medications or assist with exercise prescribed by a health care provider. Home health care may be covered by health insurance or Medicaid or Medicare.
In contrast, home care services include transportation assistance to get to doctor’s appointments, go to the grocery store or other places; assistance with safely bathing and grooming; medication reminders; providing companionship to thwart loneliness and more. Home care is privately paid for or by long-term care insurance.
In many instances home care and home health care may overlap. For example, an in home caregiver may come to the home to help someone recovering from illness by preparing breakfast and assist with getting dressed in preparation for the physical therapist.
The choice to purchase long-term care insurance is a personal one. There are many costs to consider and of course no one knows exactly how long they might live or if an illness will strike or not. When reviewing the costs of long-term care insurance, one should compare it to estimates for nursing home costs, then factor in chronic conditions that might affect premiums or even the ability to get the insurance, inflation, and more. The Home Care Association of America’s 2016 “The Value of Home Care” report points out that home care can reduce the need for doctor visits and even reduce the chance of hospital readmissions, so the cost of long-term care insurance or privately paying for home care can potentially save money.
It should also be factored in that as people live longer, there are going to be fewer family caregivers available to help out. An AARP report found that the number of family caregivers will decrease from a ratio of 7:1 to 4:1 by 2030. Also, family doesn’t always live close by in order to help with quick things like a run to the store, or to stop by and do a little housework or yardwork.
Talk to your family, financial planner and others when assessing the cost of long-term care options and long-term care insurance. The American Association for Long-Term Care Insurance can be a resource for those looking to buy this insurance or understand their existing coverage.
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