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What Are the Real Costs of Home Health Care?

Nov 15, 2018 by Clark Bongaardt

In-Home Care is an Affordable Option

The idea of seniors staying in their homes as opposed to an assisted living facility or senior community is not new. For many, it is the best option compared to moving into the many developments that cater to seniors, from the active to housebound. There are even adult day care centers. With baby boomers reaching their golden years, staying in the home they have lived in for decades is not just about their health needs, but their independence and dignity. Also, the need for in-home care arises when a family member realizes that he or she cannot care for their parent or loved one.

There are many health care agencies that are banking on this trend. However, it is still costly to have in-home care, whether home health or home care. There is even specialized care, such as Alzheimer’s and dementia. It’s important to note that this type of specialized care is mostly found in nursing homes and senior living facilities. Before we get into the costs of home health care, let’s explore the difference between home health care and home care.

Home health care is when a nurse (RN or LPN) or a certified nursing assistant visits the home for medical reasons, such as administering shots, changing a dressing or assisting with a ventilator. They can also be referred to as geriatric or nurse aides. Home health care can also include physical, occupational and speech therapies. Home care (also known as personal care, senior care, interactive caregiving and companion care) is when a person visits the home for non-medical services, such bathing, personal grooming, transportation, and transitional care. They also provide companionship as well as supervision. They not only make meals but take their client on walks or create activities to keep the senior physically active and alert. Home care aides are cheaper than home health aides because they do not have medical skills. They also do not experience federal regulation. Home care agencies provide home care aides as well as home health care aides. There are some agencies that offer care services for both types of care providers.

Average In-Home Care Costs Throughout the United States

Since both home and home health aides are paid on an hourly basis, their rates vary depending on the geographical area (and skills). The difference between states can be as much as 50 percent. According to Genworth Financial, the national average in-home care can cost as much as $4,000 a month. There are also daily and overnight rates. Daily rates are different than hourly because this payment schedule is for seniors who need help or care 24/7. The rate can range from $200 to $400 per day. Overnight rates are less because the caregiver is there for a shift (10 – 12 hours). The rate can range from $100 - $200 per shift. An overnight care provider is necessary if the senior gets up frequently during the night and needs help with going to the bathroom. Or, the senior has Alzheimer’s and a caregiver is needed to prevent wandering. If we were to look at the average hourly cost of in-home costs in a sampling of states, there are some states that are higher than other due to many factors, including the cost of living in the area, the number of hours and the services needed:

  • Mississippi $19.00
  • Arkansas $19.00
  • North Dakota $28.75
  • Alaska $26.75
  • Texas $18.00
  • Georgia $19.00
  • Minnesota $24.75
  • New York $22.00
  • Washington $23.00
  • Louisiana $18.00
  • Alabama $17.00
  • Rhode Island $23.50
  • California $22.00
  • Maryland $20.75
  • Tennessee $18.75
  • Massachusetts $25.50

 

In-home care (personal care) will be less expensive than home health care due to the type of services. Also, the cost of medical equipment and supplies must be taken into consideration.

Medicare and Medicaid and Their Role in Senior Care

When we think of getting older, the first thought is retirement and how to afford it. But we also need to think out our future health care needs, especially if you have a medical condition prior to age 65. This is where the terms Medicaid and Medicare come into the picture. It’s important to know the difference between the two, just like home care and home health care. Medicaid is a federal and state program that helps cover the medical costs for people with low incomes. It also covers nursing home and personal care services, unlike Medicare. Medicare is a single-payer national insurance program that is funded by payroll tax, premiums and surtaxes from beneficiaries and general revenue. It is for Americans age 65 and older as well as for younger people with disabilities. On average, Medicare only covers half of the healthcare costs, which is why it is vital to get supplemental healthcare insurance.

People can also get long-term insurance. This is an insurance product (like other insurance policies) that helps cover the cost associated with long-term care. The most common type is personal care, also known as elderly care or senior care. This is in-home care to help with activities with daily living, such as dressing, grooming, and mobility. It also includes meals, adult day care, light housework, grocery shopping, and transportation services.

 

How to Pay for Home Health Care   

When this subject comes up, it can be overwhelming for people (and not just for seniors or their family). However, there are several ways to pay for home health care along with many federal and state resources. For example, according to the Centers for Medicaid and Medicare Services, the breakdown of paying for home health care services looks like this:

 

  • Medicare 41%
  • Medicaid 24%
  • Federal & State aid 15%
  • Out-of-pocket 10%
  • Private insurance (i.e. long-term insurance) 8%
  • Other 2%

 

Unfortunately, you can’t just sign up for Medicare Home Health Care (as opposed to Medicare). You must qualify for it. This comes down to getting documentation from your doctor. You must be under a doctor’s care, are housebound and need a home health care service, such as skilled nursing care, occupational therapy or physical therapy. The home health agency you employ your home health aide from must be Medicare approved. Plus, the number of hours of having a nurse is limited. He or she can only work less than 7 days a week or less than 8 hours a day, over a 21-day period.

If you are a veteran, there is the Housebound benefit. Like Medicare, there are qualifications. You must be permanently disabled and housebound or you have more than one permanent disability. The household income must be less than $15,000 or $19,000 with dependents. There is also the Homemaker and Home Health Aide Care. These services do not include skilled nursing, but case management and personal care. They are part of the VA Standard Medical Benefits Package for veterans that meet the clinical needs of the package. Additional benefits include Skilled Home Health Care, Telehealth Care, and Home Based Primary Care. Check with your local VA office for more information.

Comfort Keepers Provides Quality Home Care

If you need in-home care or have questions about home care, please contact us. Our staff is happy to provide the help you need to ensure your elderly parent (or loved one) is well-taken care of in the comfort of your/their home. We are located in Springfield (PA) and service communities throughout Delaware County. We provide in-home care to adults who are sick, disabled or seniors. Contact us today for a free in-home assessment with one of our Care Coordination Team members!

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