Resources and FAQs
HOW DO I PAY FOR SERVICES?
WHO REGULATES THE HOME CARE INDUSTRY?
WHO PAYS FOR THESE SERVICES?
HOW DO I KNOW THE PERSON YOU ARE SENDING TO MY HOME IS EXPERIENCED AND DOES NOT HAVE A CRIMINAL RECORD?
ARE YOU BONDED & INSURED?
HOW LONG HAVE YOU BEEN IN BUSINESS?
IF I HAVE A LONG TERM CARE INSURANCE POLICY CAN THEY PAY YOU DIRECTLY?
WHERE ARE YOU LOCATED?
IS THERE FLEXIBILITY IN THE SERVICES YOU PROVIDE?
MISCONCEPTIONS ABOUT HOME CARE COVERAGE THROUGH MEDICARE AND YOUR HEALTH INSURANCE BENEFITS
There is a common misconception by many that Medicare and Health Insurance will cover all related expenses associated with their “Home Care” needs. Unfortunately, this is not true. There are many services that are not covered through Medicare & Health Insurance that are essential in providing adequate coverage for seniors while attempting to remain in the comforts and safety of their own home. Let’s take a moment to review what is covered through Medicare and Health Insurance and what’s not:
WHAT IS COVERED?
HOME HEALTH CARE – Medicare and Commercial Health Insurance benefits often provide the following services:
-Skilled Nursing (which includes: Blood Pressure checks, diabetic teaching, medication management)
-Social Worker Visits
Most Home Health Companies will provide a complementary C.N.A. or Certified Nurses Aide (this usually consist of 1-2 visits per week for no more than 1 hours at a time (this may includes a bath, food preparation and light housekeeping) usually for a limited time frame. The remainder of the time Family is expected to assist their loved ones with their Activities of Daily Living or ADL’s.
HOSPICE CARE – focuses on the Spiritual, Physical and Emotional Support for end of life care.
Services usually include:
-Social Workers Support
-Education to Patient and Family
-Registered Nursing Care
-Pain Management Support
-Crisis Care may be provided but for a limited time.
WHAT ISN’T COVERED?
Non-Medical Home Care – these agencies fill the “Gap” where traditional “Home Health and Hospice” leave off.
-Grooming and Personal Hygiene
-Bathing and Dressing Assistance
-Grocery Shopping and Errand Services
-Companionship at Facilities and Hospitals
-Picking up Prescriptions and much more.
These services are often the most critical factors in allowing one to remain in the comforts of their own home. Family members are often unable to assist for numerous reasons; that’s why Non-Medical Home Care agencies are so instrumental in assisting at home with one’s ADL’s. Clients usually pay “Out of Pocket” or “Private Pay” at a rate range of $18-$28/per hour. Services are often provided by a Certified Nurse’s Aide or experienced Caregivers. Some seniors may be fortunate to have Long Term Care Insurance that may help supplement the cost of “non-medical home care.”
WHAT ARE YOUR OPTIONS?
Long Term Care Insurance – can pay for services rendered if an individual needs assistance and unable to perform certain activities of daily living without “hands on or standby” assistance from some one else.
Most policies require needing help with at least 2 of the following ADL’s:
Many seniors are unaware that it may not be too late to purchase a Long Term Care Insurance Policy. Many policies are designed to assist you with “your needs in mind.” For the younger generations who strive to stock pile for their retirement, Long Term Care policies can be the most critical factor in Retirement Planning that is often overlooked. The cost of care at retirement is often what depletes one’s savings. Long Term Care Insurance can help preserve your savings because they are designed to pay for the services that Medicare and Health Insurance will not. For more information call your local insurance agent or financial planner to determine if you qualify.
OTHER GOVERNMENT PROGRAMS AND RESOURCES:
-Community Based Alternatives
-Primary Home Care
-Alamo Area Counsel of Government
-VA Aide and Attendance
These are State, Federal and County Programs that will help pay for the above services. However, qualifying may be difficult and there are often limits to what services you can receive. Often you may be required to “Spend Down” or have little to no assets to qualify for these programs. For more information please visit this website: www.elderoptionsoftexas.com/article _how_texas_Medicaid_works_veterans_benefits.htm
If you are looking to remain in your own home, and needing additional assistance you may want to consider calling a non-medical homecare agency to supplement what Medicare and your Health Insurance benefits do not provide. When looking for an agency be certain that the agency thoroughly conducts background checks on its employees and that they are licensed, bonded and insured.
-Bexar Area Agency on Aging – for elder care resources please call 210-477-3275
-Caregiver Support – www.agingcare.com
-Family Caregiver Stress-Busting Support Program – 800-272-3900
-Dignity First – (Experts in Dementia Care) www.dignityfirst.net (also available on YouTube search for the Dignity First Doctors Channel for questions and answers about dementia.)
-Fellowship Hospice -210-780-3003 or visit