Providing quality care for loved ones at home is a priority, but it can also raise many questions. We’re committed to supporting you on this journey. Our FAQ page addresses common concerns about home care services, costs, and insurance coverage. Let’s work together to ensure your loved one receives the care and comfort they deserve.

What is home care?

Home care is support and health services provided in a person’s home. It includes assistance with daily activities such as bathing, dressing, meal preparation, and medication management, as well as medical services like wound care and physical therapy. Home care is designed to help individuals maintain their independence and quality of life in the comfort of their own home. It can be short-term, such as after surgery, or long-term for chronic conditions or elderly care.

What is home health care?

Home health care is medical and supportive care provided in a person’s home. It includes services like skilled nursing, physical therapy, occupational therapy, speech therapy, and medical social services. The goal is to help individuals recover from illness, injury, or surgery, manage chronic conditions, and maintain their independence. Home health care is typically prescribed by a doctor and can be covered by insurance, including Medicare, for eligible patients.

What is a home care aide?

A home care aide assists individuals with daily activities like bathing, dressing, grooming, meal preparation, and light housekeeping, providing companionship and support to help them remain independent at home.

What is palliative care at home?

Palliative care at home provides relief from symptoms, pain, and stress of serious illness to improve quality of life. It includes symptom management, medical care, emotional support, care coordination, and family support. It can be provided at any stage of illness alongside curative treatments.

What is hospice care at home?

Hospice care at home is end-of-life care provided in a patient’s home, focusing on comfort and quality of life. It includes pain management, medical care, emotional and spiritual support, personal care, and respite for caregivers.

It’s typically for patients with a prognosis of six months or less to live and is often covered by Medicare, Medicaid, and private insurance.

Does hospice cover 24-hour care at home?

Hospice care generally does not cover 24-hour care at home in Pennsylvania. Hospice services focus on intermittent visits by healthcare professionals, such as nurses, aides, and therapists, to provide necessary medical care, pain management, and support.

However, hospice can help arrange for continuous care during brief periods of crisis or severe symptom management. Families may need to supplement with private pay caregivers for around-the-clock care.

How much does private home care cost per hour?

The cost of private home care in Pennsylvania typically ranges from $20 to $30 per hour. This cost can vary based on factors such as the specific region within the state, the level of care required, and whether the caregiver is hired through an agency or independently. For specialized care or more experienced caregivers, the rates might be higher.

How much does 24/7 in home care cost per month?

In Pennsylvania, the cost of 24/7 in-home care typically ranges from approximately $15,000 to $23,000 per month. This range can vary based on factors such as the specific location within the state, the level of care required, and whether you hire through an agency or directly with independent caregivers.

For a more precise estimate, it’s advisable to contact local home care agencies or individual caregivers in your area.

How much does in home care cost?

The cost of in-home care in Pennsylvania varies based on the type and level of care required, as well as the specific region. On average:

• Non-medical home care (assistance with daily activities): Typically ranges from $20 to $30 per hour.
• Skilled home health care (nursing care, physical therapy): Usually costs more, averaging $30 to $50 per hour.

For 24-hour care, costs can range from $15,000 to $25,000 per month, depending on the level of care needed and whether services are provided by an agency or independent caregivers. For exact costs, it’s best to get quotes from local home care providers.”

What insurance covers in-home care?

In Pennsylvania, the following types of insurance typically cover in-home care:

• Medicare: Covers skilled nursing care, physical therapy, and other home health services if specific conditions are met.
• Medicaid: Offers broader coverage for in-home care services for eligible low-income individuals.
• Private Health Insurance: Coverage varies by policy but may include certain in-home care services.
• Long-Term Care Insurance: Specifically designed to cover the costs of in-home care, assisted living, and nursing home care.
• Veterans Benefits: The VA offers programs to cover in-home care for eligible veterans.

It’s important to check with individual insurance providers for specific coverage details.

Does Medicare cover home health care?

Yes, Medicare does cover home health care in Pennsylvania if certain conditions are met. Coverage includes services such as skilled nursing care, physical therapy, speech-language pathology services, and occupational therapy. To qualify, a doctor must certify that the patient is homebound and needs intermittent skilled care. The home health agency providing the care must be Medicare-certified.

Services typically covered by Medicare include:

• Skilled nursing care on a part-time or intermittent basis
• Physical therapy
• Occupational therapy
• Speech-language pathology services
• Medical social services
• Part-time or intermittent home health aide services

Medicare does not cover 24-hour-a-day care, meals delivered to the home, or homemaker services if that is the only care needed.

How to qualify for home health care under Medicare?

To qualify for home health care under Medicare in Pennsylvania, you need a doctor’s certification, be considered homebound, require skilled nursing or therapy services, and use a Medicare-certified home health agency.

How long does Medicare pay for nursing home care?

Medicare pays for nursing home care in Pennsylvania for a limited time under specific conditions:

• Up to 100 Days: Medicare covers up to 100 days of skilled nursing facility (SNF) care per benefit period.
• First 20 Days: Medicare covers the full cost for the first 20 days.
• Days 21-100: For days 21-100, you pay a daily coinsurance amount ($200 per day in 2023).

Medicare does not cover long-term or custodial care in a nursing home beyond this period.

What happens when Medicare stops paying for nursing home care?

When Medicare stops paying for nursing home care in Pennsylvania, the individual must either qualify for Medicaid, pay out-of-pocket, use long-term care insurance, or seek help from family. Consulting with financial and legal advisors is recommended.

How to pay for nursing home care with Social Security?

To pay for nursing home care in PA with Social Security:

• Use Social Security income for part of the cost.
• Apply for Medicaid to cover remaining expenses if eligible.
• Consider Supplemental Security Income (SSI) for additional help if needed.
• Combine with personal savings and family contributions if necessary.

Talking to a financial advisor can help you figure out the best way to manage these costs.

Will Medicaid pay for 24-hour home care?

Medicaid in Pennsylvania typically does not cover 24-hour home care on an ongoing basis. However, Medicaid may cover part-time or intermittent home care services, and in some cases, more extensive in-home care through specific waiver programs designed for individuals with significant needs. These programs might provide more comprehensive support but usually not continuous 24-hour care.

For those needing 24-hour care, other options such as combining Medicaid benefits with personal funds, long-term care insurance, or other community resources might be necessary. It’s best to contact the Pennsylvania Department of Human Services or a Medicaid specialist for specific guidance and available programs.

Does Medicare cover palliative care at home?

Yes, Medicare covers palliative care at home in Pennsylvania. Palliative care is included under Medicare Part B and sometimes under Part A if it is part of a hospital or skilled nursing facility stay.

This coverage includes:

• Visits from healthcare professionals like doctors, nurses, and social workers.
• Medical services to manage symptoms and pain.
• Counseling and support for emotional and psychological needs.
• Some medications and medical supplies related to the serious illness.

Patients must meet certain eligibility criteria, including having a serious illness that requires palliative care services.

How much does the VA pay for in-home care?

The VA offers in-home care benefits in Pennsylvania through various programs, with payments ranging from a few hundred to several thousand dollars per month. For example, the Aid and Attendance benefit provides up to $2,229 per month for a single veteran. The exact amount depends on the veteran’s needs and eligibility.

Who is eligible for the veterans home care program?

To be eligible for the Veterans Home Care Program in PA, you must be an honorably discharged veteran who needs help with daily activities and meets income, asset, and medical need criteria. Some programs may require a service-connected disability.

When should someone with dementia go into a care home?

Deciding when someone with dementia should move into a care home depends on various factors related to their safety, health, and quality of life, as well as the ability of family caregivers to meet their needs. Key indicators include:

• Safety Concerns: Increased risk of wandering, falls, or accidents that can’t be managed at home.
• Health Needs: Requires 24/7 supervision or medical care that exceeds what can be provided at home.
• Caregiver Stress: Caregivers are experiencing significant physical, emotional, or financial strain.
• Behavioral Issues: Severe behavioral changes that are difficult to manage, such as aggression or severe agitation.
• Decline in Self-Care: Inability to perform daily activities like bathing, dressing, or eating, despite assistance.
• Isolation: Lack of social interaction or engagement that affects well-being.

Consulting with healthcare professionals can help determine the appropriate time for transitioning to a care home

Does Medicare cover home health care for dementia?

Yes, Medicare covers home health care for individuals with dementia in Pennsylvania if specific conditions are met. The coverage includes:

• Skilled Nursing Care: Part-time or intermittent skilled nursing care.
• Therapy Services: Physical, occupational, and speech therapy.
• Home Health Aide Services: Part-time or intermittent personal care services.
• Medical Social Services: Support for social and emotional needs.

To qualify, a doctor must certify that the patient needs home health care, the patient must be homebound, and the care must be provided by a Medicare-certified home health agency. Medicare does not cover 24-hour care or custodial care.

Who qualifies for home health care services?

To qualify for home health care services in Pennsylvania, an individual must meet the following criteria:

• Doctor’s Orders: A doctor must certify that the patient needs home health care and create a care plan.
• Homebound Status: The patient must be considered homebound, meaning it requires significant effort to leave home and they need assistance.
• Skilled Services Needed: The patient must need intermittent skilled nursing care, physical therapy, speech-language pathology, or continued occupational therapy.
• Medicare-Certified Agency: The services must be provided by a Medicare-certified home health agency.

Meeting these criteria allows individuals to receive home health care services, often covered by Medicare.

How to get home health care?

To get home health care in PA:

• Consult your doctor for an evaluation and care plan.
• Obtain a doctor’s order for home health services.
• Find a Medicare-certified home health agency.
• Have an initial assessment by the agency.
• Start receiving care based on your plan.
• Verify insurance coverage and payment options.

Following these steps will help you access home health care services in Pennsylvania.

Who pays for hospice care at home?

Hospice care at home in Pennsylvania is typically covered by Medicare, Medicaid, private insurance, veterans’ benefits, or out-of-pocket payments. Some non-profit organizations may also offer free or reduced-cost services based on need.