Does My Insurance Cover Home Care?

Just about every week we receive calls, typically from spouses or adult children of seniors, asking what their insurance covers with respect to their loved one's need for home care or some type of on-going assistance in the home.

The simple answer is that, unless the person needing care has a Long Term Care Insurance policy, there is no coverage at all for in-home caregiver services. Not under Medicare, not under Medicare supplemental, not through your private insurance policy. None.

Long term care facilities and senior living communities are crowded and ubiquitis not because people don't prefer to live out their years in the comfort of their home but because the cost of in home care is among the few medical necessities that is not covered or shared in any way by Medicare or a private insurance plan.

Even those with long term care insurance, which is the only type of policy that covers any type of caregiver and/or in-home services, may not receive the type of benefit and cost coverage that would allow them to stay in their home.

Navigating any insurance policy and its nuances is difficult under even the best of circumstances. Long term care insurance plans are no less confusing to the average consumer. Long term care insurance, like a 401K, is better to invest in sooner in life because the policy's annual cost is based on the insured's age.

The Department of Health and Human Services offers an online resource and guidance dedicated specifically to long term care insurance. I recommend making time to read through this surprisingly user friendly site to familiarize yourself with the basics of long term care policies: http://www.longtermcare.gov/LTC/Main_Site/index.aspx

My guess is that most of you read this blog with your parents and/or loved one's in mind. For seniors, a long term care policy may be found to be prohibitively expensive. Maybe after doing some calculations you will find that paying for care out of pocket makes more sense than purchasing a policy now. 

My advice is that you think forward and consider shifting focus to what your needs may be in 20 years. If you have been forced to learn about caregiver and home care costs by changing circumstance or a medical episode relating to your parents or a loved one try to accept this challenging moment as an opportunity to learn from this experience and better prepare for your own future.