For the majority of families, home care is an out-of-pocket expense. Most traditional health insurance providers, including Medicare and private insurers, do not cover non-medical home care services like personal care, household support, or transportation assistance.
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Average Cost: Traditional home care agencies typically charge around $40 per hour, with minimum requirements of 4 hours per visit and 3 visits per week. This amounts to at least $500 per week, even if you don’t need that much care.
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Tandem Care Advantage: Unlike traditional agencies, our On-Demand and Targeted Care Services allow families to get just the right amount of care without unnecessary costs. Clients who choose these services save up to 50% compared to Companion Care services, ensuring they receive essential support without overpaying or committing to more care than needed.
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If you or your loved one qualifies for Medicaid (Medi-Cal in California), you may be eligible for In-Home Supportive Services (IHSS), a program designed to provide caregiving assistance for those with financial and medical needs.
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How It Works: IHSS provides funds for hiring caregivers, including family members in some cases, to assist with daily tasks.
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Eligibility: This program is based on income and medical necessity. An application is required, and the county conducts an assessment to determine the hours and type of support needed.
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Limitations: IHSS can be an excellent resource for those who qualify, but availability may be limited, and the application process can take time.
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If you have a Long-Term Care Insurance (LTC) policy, it may cover some or all of your home care expenses. LTC insurance is designed to help with the costs of care when an individual can no longer perform certain activities of daily living (ADLs), such as bathing or dressing.
Key Points to Know:
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Coverage varies by policy; some may have waiting periods or specific requirements for eligibility.
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Policies often reimburse for care after services are provided, requiring you to pay upfront.
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It's important to review your policy or contact your provider to understand coverage details.
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Insurance-based care, such as home health or hospice services, focuses exclusively on medical assistance and is not designed to provide the broader support offered by non-medical home care services like personal care or household assistance. While these services are covered by Medicare or private insurance, the coverage is often limited in scope and duration.
Key Points About Home Health Care:
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Purpose: Home health is typically prescribed following a hospitalization, surgery, or accident and focuses on medical necessities, such as wound care, medication management, or physical therapy.
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Limited Visits: Coverage usually includes 1-2 visits per week, lasting 45-60 minutes per visit, and is focused on tasks deemed medically necessary.
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For example, assistance with bathing is only provided if there is a medical need for a nurse or therapist to oversee it.
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Short-Term Care: Home health services are typically covered for up to 30 days at a time and require a physician’s order. Extensions may require reauthorization but are rarely granted for long-term needs.
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What It Doesn’t Cover: These services do not include non-medical support (home care) like meal preparation, companionship, housekeeping, or errands.
Key Points About Home Health Hospice:
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End-of-Life Support: Hospice is designed for individuals with a terminal diagnosis, focusing on comfort and symptom management rather than curative treatment.
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Intermittent Visits: Hospice teams provide medical oversight, counseling, and occasional visits to assist with comfort measures, but they do not provide full-time or continuous in-home care.
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Supplemental Care Needed: Families often still need to arrange non-medical home care services to assist with personal care, household support, or companionship.
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