Affordable Care

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Private pay home care is nonmedical home care that's paid for out of pocket. The services provided help seniors to live at home rather than moving to a senior living facility. In 2021, nearly 65% of families paid for home care services out of pocket, according to a survey conducted by Home Care Pulse.

Understanding the various ways, you can use personal funds to pay for home care can seem overwhelming. 

 Nonmedical home care services offer support for seniors and family caregivers. The most common types of home care include the following:

• Personal care, which provides assistance with activities of daily living (ADLs) such as mobility, bathing, and dressing
• Homemaker services, which offers help with household tasks such as light housekeeping and meal preparation
• Companion care, which provides social interaction to help reduce the impact of loneliness

Keep in mind, there are differences between nonmedical home care and home health care. While both offer support for seniors in their homes, home health care provides medically necessary, short-term care that is typically prescribed by a doctor and often covered at least in part by insurance.

 The Home Help program is designed to support individuals who wish to live independently in their home rather than live in an adult foster care home, home for the aged, or nursing facility. A range of services are available to anyone that needs assistance to maintain the ability to live safely in their home.  

The Home Help program may pay for the following activities of daily living:

• Eating or Feeding
• Bathing
• Dressing
• Grooming
• Moving throughout the home
• Transferring from one position to another
• Using the toilet 

If you qualify for one of the above activities of daily living, you may also receive assistance with the following:

• Administering or setting up medicine
• Laundry
• Light housework
• Meal preparation/clean up
• Shopping for essential items
• Travel for shopping/laundry

Medicare Part A or Medicare part B

cover eligible home health services as long as you need part-time or intermittent skilled services and you’re “homebound,” which means:

• You have trouble leaving your home without help (like using a cane, wheelchair, walker, or crutches; special transportation; or help from another person) because of an illness or injury.
• Leaving your home isn’t recommended because of your condition.
• You’re normally unable to leave your home because it’s a major effort.

Covered home health services include: 

• Medically necessary part-time or intermittent skilled nursing care, like:
  • Wound care for pressure sores or a surgical wound
  • Patient and caregiver education
  • Intravenous or nutrition therapy
  • Injections
  • Monitoring serious illness and unstable health status

All enrolled Veterans are eligible for Homemaker Home Health Aide Care IF they are eligible for community care and meet the clinical criteria for the service and it is available. Services may vary by location. A copay for Homemaker and Home Health Aide services may be charged based on your VA service connected disability status.

Services are based on your assessed needs. Talk with a VA social worker to find out what specific help you may be able to receive.

Examples of daily activities you may be able to receive help with include:

• Eating
• Getting dressed
• Personal grooming
• Bathing
• Using the bathroom
• Moving from one place to another
• Grocery Shopping

You can continue to receive services for as long as you need extra help with your daily activities.

PACE covers in-home care, adult day care, checkups, hospital and nursing home stays, prescriptions and some transportation for medical purposes. It can also pay for training, support and respite for family caregivers.

Local PACE organizations work with medical providers who form the recipient's health care team. If the team decides your loved one needs care that Medicaid or Medicare doesn't provide, PACE still may cover it.

To be eligible, someone must be:

• 55 or older
• In need of nursing home-level care as certified through your state
• A resident of an area with a PACE organization
• Able to live safely in the community with help from PACE. People with Medicare, Medicaid or both can qualify although if you have Medicare only you might be charged a monthly premium. Those not covered through either program can pay for PACE privately.