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The majority of our clients are “private-pay” – our fees are paid directly by the client or their families. However, a growing percentage has some third-party payer source that covers all or part of in-home care services. If you have some form of insurance that covers long-term care, Amdal In-Home Care will work with you and your insurer to determine coverage. Each policy is different in what it may cover, elimination periods, and how care needs to be delivered, documented, and billed. We encourage you to call us if you have questions or are unsure about your policy’s coverage. We will work with you to ensure you obtain the maximum benefit to which you are entitled.
In addition, you or your loved-one may be eligible for special governmental benefits that cover in-home care services, and we can help you identify those as well.
Here is a summary of different payer sources, with some notes about each:
Medicare
Generally speaking, this coverage is medical in nature, and only covers “custodial” care if it is directly related to a medical need while the patient is under an active “home health order,” where the patient is also receiving in-home visits from an Registered Nurse, LVN, or in-home therapist, such as a Physical Therapist. Non-medical in-home care agencies can't bill Medicare for these services, it must be billed by a licensed home health agency.
Medi-Cal/Medicaid
This program is provided in each state and funded with federal, state and local monies. You must be age 65 or above and financially indigent. Each state has financial requirements for eligibility. This program is usually managed at the county level and is not open to the private sector. If financially eligible there are benefits available for custodial care coverage. In the State of California you can call the Area Agency on Aging to obtain the In-Home Support Services program in your area. Their number is 1-800-510-2020.
Long-Term Care Insurance
This can be a stand-alone policy or an add-on to a health-insurance policy. Amdal In-Home Care regularly bills Long-Term Care insurance, and assists families in determining their eligibility and meeting whatever requirements their policy has in place. These policies can vary greatly in what is covered, and for how long.
Worker’s Compensation
Amdal In-Home Care does provide services under Worker’s Compensation coverage, where an employee has become injured or disabled while on the job.
Veterans Aid and Attendance Benefit
There is a pension benefit available through the Veteran’s Administration to some lower-income veteran’s and their widowed spouses. Contact us to find out more if you think your loved one was enlisted during a period of active conflict.
County AIDS Programs, VA Hospitals, Care Giver Resource Centers
There are a number of state, county and local programs that assist low-income seniors and certain medical diagnosis. There are also programs to help those affected by HIV. These programs are designed specifically to help people fund in-home services. If you think you might qualify, call Amdal In-Home Care and we will help you identify these programs as appropriate.
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