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Who Pays for Home Health Care for Seniors?
Date Updated: December 9, 2024
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Public funding often pays for home health care for seniors. However, financial assistance only lasts as long as doctors prescribe medically necessary services. If physicians no longer deem services essential, individuals must typically cover costs themselves or consider alternative care types.
Medicare Coverage of Home Health Care
As of January 2024, seniors aged 65 and older account for 89.6% of the nation’s 67 million Medicare beneficiaries. The federal health insurance program pays for certain home health care services for qualifying homebound seniors. Coverage may fall under Medicare Parts A or B. A doctor or nurse practitioner must certify that an individual requires intermittent home health care support. Medicare doesn’t pay for full-time in-home care.
Funding covers part-time skilled nursing care, such as medication administration, wound care and IV therapy, in the comfort of a senior’s home. It also pays for aide-delivered personal care for those receiving skilled nursing services. Financial assistance extends to physical, occupational and speech therapy, medical social services and durable medical equipment, such as mobility aids, oxygen equipment and blood sugar meters.
Medicaid and VA Coverage of Home Health Care
Although rules and coverage vary among states, original Medicaid or Home and Community-Based Services waiver programs pay for home health care for qualifying seniors. Eligibility criteria generally include limited financial means and functional care needs, as confirmed by a doctor. Standard services encompass skilled nursing and rehabilitative therapies.
VA Health Care pays for home health services for eligible veterans. Coverage depends on individual circumstances and location but may include skilled nursing, pain management, assistance with certain daily living activities and therapies.
Self-Funded Home Health Care and Other Care Options
When seniors don’t qualify for financial assistance programs or eligibility ends, they must fund home health care services using private means. Options include using savings or income, reverse mortgage loans and long-term care insurance.
Older adults who require 24/7 supervision and medical services generally find nursing home care more appropriate than home health care. Most public funding options don’t pay for around-the-clock care at home. As an individual’s condition improves, they may transition back to home with intermittent visiting support. Non Medical home care often suits those who need help with daily tasks but have limited clinical needs.