In-home caregivers come to the home to help with activities daily living, such as light housekeeping, grocery shopping, meal preparation, medication reminders, and grooming. And while home health care aides can also provide personal care assistance, the opposite is not true (personal care assistants can not provide in-home health care).
Some of the options for in-home care and home health care services can be found below.
Home Care Services
Personal care assistants do not provide medical care, but otherwise, care can be tailored specifically for each individual’s needs. Available services include:
- Assistance with ADLs
- Assistance with mobility
- Grocery shopping and meal preparation
- Housekeeping and cleaning services, including laundry
- Transportation to doctor’s appointments, social activities, and more
- Companionship, social engagement, and cognitive stimulation
- Medication management (but not administration)
- Respite for family caregivers
Home Health Care Services
Home health care aides provide more skilled medical care than personal care assistants. The care one receives will depend on their own medical needs, but available services include:
- Skilled nursing, first aid, and wound care
- Post-surgery recovery care
- Physical therapy
- Occupational therapy
- Respiratory therapy and assistance with oxygen tanks and tubing
- Assistance with maintaining and cleaning feeding tubes, catheters, and other medical devices
- Medication administration, including injections
- Assistance managing and monitoring chronic conditions
- Blood withdrawals
How Much Does Home Care Cost?
According to the Genworth Financial Cost of Care Survey, in-home care costs about $24 an hour. That comes out to $1,950 per month for 20 hours of care a week, or $3,900 per month for 40 hours of care per week. Home health care is slightly more expensive at an average rate of $25 an hour.
These figures are the national average, so average costs in your state or city may be quite different. For example, in Vermont, where senior care tends to be more expensive than the national average, 20 hours per week of in-home care costs an average of $2,362 per month, about $400 higher than the U.S. average. Meanwhile, in Louisiana, the same amount of in-home care costs just $1,463 per month, on average.
Financial Assistance for In-Home Care
It’s always an option to pay out-of-pocket for in-home care, but many people utilize some form of financial assistance to make the cost more manageable. Below are some of the most commonly used resources available to pay for home care.
- Long-Term Care Insurance: Standard health insurance will not pay for personal care assistance, but some long-term care insurance policies may. While long-term care (LTC) insurance policies are specifically designed to cover senior care, the exact coverage details can vary depending on several factors, most notably the age of the beneficiary when they signed up for their policy. LTC insurance oftentimes will not cover in-home care until the client needs help with at least two ADLs. Check the details of your loved one’s policy to see if in-home personal care assistance is a covered benefit.
- Medicare: Original Medicare does not cover standard in-home care as it is considered “custodial care” and not medical. However, it may cover personal care assistance if it is delivered with home health care services from the same provider. Additionally, some Medicare Advantage and Medicare Supplement plans may cover in-home care services.
- Medicaid: Medicaid does not cover custodial care, which includes standard in-home care. However, many states have some form of Home and Community-Based Services (HCBS) waiver, designed to expand the state’s Medicaid benefits to cover additional services such as personal care assistance. Medicaid does always cover home health care for those who meet both medical and financial eligibility requirements.
- Life Insurance: Though one’s life insurance benefit is intended to be accessed after they pass, in some cases it makes more financial sense to access the funds early and use the life insurance payment to finance long-term care. This may be in the form of an “accelerated death benefit” from the insurance provider, or you may look into selling the policy to a third-party for a cash payment. Look into the specifics of your loved one’s policy to see if this option makes sense for your situation.
- Veterans Benefits: In addition to a VA pension, some veterans are eligible for the Aid and Attendance (A&A) benefit, an additional monthly payment intended to be used towards paying for long-term care. One of the eligibility terms is needing help with one or more ADLs, so most veterans in need of in-home care will likely qualify. You can learn more about the benefit and apply directly on the VA website, or apply in person at your local VA office.
- Reverse Mortgage Loans: Reverse mortgages are a loan that one can take against the value of their home, essentially converting part of their home’s value into a cash payment while they continue to live there. The only federally-insured, and thus most reliable, form of a reverse mortgage is the Home Equity Conversion Mortgage (HECM), available to adults age 62 and over to help finance long-term care or other expenses. No matter which type of reverse mortgage one chooses, the loan will need to be repaid with interest once the home is eventually sold.