Will Your Insurance Cover Senior Home Care Services in Dayton, OH?

May 16, 2022 at 5:00 AM

Navigating care services for your senior loved one is challenging enough without having to also determine whether or not an insurance policy will cover costs. To help you learn more about the costs of senior home care services in Dayton, OH and if insurance provides coverage, Miami Valley Homecare has created this guide.

Home Care Services versus Assisted Living versus Nursing Home

Depending on your loved one’s situation, and your available resources, you’ll want to understand the difference between home care services, assisted living, and nursing homes, and what kind of care they provide. Of course, you’ll also want to know their average costs.

Home Care

Home care services offer companionship, transportation, and help with everyday activities like dishes, laundry, cooking, and medication management. Home care can also help with grooming and clothing as well. Home care is a personalized service that allows your loved one to continue living in their home but still ensures they receive the care they need.

In 2021, home care services averaged around $4,500 a month, according to the American Association for Long-term Care Insurance.

Assisted Living

Assisted living communities provide housing and care services to seniors who are unable to live independently. An assisted living facility offers seniors meal services, housekeeping services, social activities, as well as medication assistance. An important distinction between assisted living and home care is that seniors live in a community rather than their own homes. And assisted living facilities often do not have skilled nurses on staff.

Assisted living average costs were $5,200 in 2021 according to the same report from AALTCI.

Nursing Homes

The biggest difference between nursing homes, home care services and assisted living, is that nursing homes are for seniors who need more than basic care and assistance. Nursing homes offer around-the-clock medical care, as well as assist with a variety of daily life activities.

The monthly average cost for a nursing home in 2021 was $7,900.

Things to Consider

While home care was the most affordable type of care on average, it’s important to keep in mind that the type of care you choose for your loved one at first may not be the kind of care they need in a month’s or year’s time. To pay for all three kinds of care, people may choose to open a long-term care insurance policy. But depending on your loved one’s current insurance coverage, long-term care may or may not already be covered.

Medicare

Medicare does not provide long-term care coverage for home care services unless an individual is unable to leave their home without assistance. On Medicare, your eligible loved one can qualify for skilled nursing care, home health aide services, as well as physical or occupational therapy.

Medicare does not provide home care services like help with daily activities unless their doctor requires it as part of their plan of care.

Medicaid

While Medicaid does cover assisted living care, nursing home care, and home care services in Ohio, home health service visits are defined as a four-hour visit. Additionally, services like home health nursing, visits from home health aides, or skilled therapy services must not exceed a combined 8 hours per day.

PACE (Programs of All-Inclusive Care for the Elderly)

PACE programs are growing around the United States. The goal of these programs is to help seniors receive home care services so they do not have to be placed in a nursing home. PACE covers in-home care, adult daycare, hospital and nursing home stays, as well as transportation for medical necessities. In addition, PACE offers training and support for family caregivers.

Depending on your loved one’s situation, and whether or not Medicaid or Medicare is currently covering some care services for them, you may qualify for PACE in Ohio.

If you’re looking for senior home care services in the Dayton, OH area, Miami Valley Homecare can help. You can find out more about the home care services we provide on our website.