Insurance & Pricing
Understanding payment options is key to planning for home health care. We accept Medicare, Medicaid, and most private insurance plans to make quality care accessible.
Medicare Coverage
Medicare Part A and Part B cover eligible home health services. For patients who qualify, there is typically $0 out-of-pocket cost for covered services.
Key Requirements for Coverage:
- Under the care of a doctor with a plan of care
- Require intermittent skilled nursing or therapy
- Certified as homebound by your physician
- Services provided by Medicare-certified agency
What is "Homebound"?
You have difficulty leaving home without help (cane, wheelchair, walker, or another person), or leaving home is not recommended due to your condition. Short absences for medical appointments or religious services are allowed.
What Medicare Covers:
- Part-time or intermittent skilled nursing care
- Physical therapy services
- Occupational therapy services
- Speech-language pathology services
- Medical social services
- Home health aide services (with skilled care)
- Medical supplies for home health
What Medicare Doesn't Cover:
- 24-hour continuous care at home
- Prescription medications
- Meals delivered to your home
- Homemaker services (cleaning, laundry)
- Personal care when not receiving skilled services
Medicaid Coverage
Medicaid provides home health care benefits in all 50 states, though specific services and eligibility vary by state.
What Medicaid Often Covers
- Medically necessary skilled nursing and therapy
- Personal care services (ADL assistance)
- Homemaker services and adult day care
- Respite care for family caregivers
- Home modifications and medical equipment
Key Requirements
Financial Criteria:
Must meet strict state-specific income and asset limits to qualify.
Functional Criteria:
Must demonstrate medical or functional need for care, often requiring "nursing home level of care" for waiver programs.
Note: Coverage varies significantly by state. Contact us to verify your specific Medicaid benefits.
Private Insurance Coverage
Many private health insurance plans cover home health care, but coverage varies widely by policy.
What to Check in Your Policy:
Our intake specialists can help you verify your insurance benefits before we start care. Contact us for a free benefits verification.
Private Pay Options
If services aren't covered by insurance or you prefer to pay directly, private pay is always an option.
Factors Affecting Cost:
Geographic area and local market rates
Type and complexity of services needed
Number and duration of visits per week
National Average (2024):
The national average monthly cost for in-home care is approximately $5,417. Skilled services typically cost more per hour than non-medical aide services.
Contact us for a personalized quote based on your specific needs and location.
Financial Assistance Programs
Several programs can help offset the cost of home care for eligible individuals.
Veterans (VA) Programs
The Department of Veterans Affairs offers Aid and Attendance pension providing financial assistance to qualifying veterans and their spouses for home care services.
PACE Program
Programs of All-Inclusive Care for the Elderly is a Medicare/Medicaid program for frail seniors covering all necessary care including in-home services.
State Programs
Many states offer nursing home diversion programs providing in-home assistance for low-income seniors who may not qualify for Medicaid.
Long-Term Care Insurance
These policies are specifically designed to cover services like home health care. Check your policy for coverage details and requirements.
Other Financial Options
Life Insurance (Accelerated Death Benefits)
Reverse Mortgages
Non-Profit Grants
Community Programs