Home Care FAQs

Choosing the right home care for your loved one is a big decision, and it’s natural to have questions about the services, process, and what to expect. At our home care agency in Philadelphia, PA, we understand that every family’s needs are unique, and we’re here to provide clarity and support as you navigate this journey.

To help you make an informed decision, we’ve compiled answers to the most frequently asked questions about home care. Whether you’re exploring options for the first time or seeking additional services for a loved one, these FAQs cover everything from the benefits of home care to how our agency ensures quality and reliability.

Read on to discover how home care can enhance your loved one’s quality of life while giving you peace of mind. If you have any further questions, don’t hesitate to reach out to our friendly team—we’re here to help!

What is home care?

Home care encompasses a range of supportive and health-related services delivered right in an individual’s residence. These services are tailored to assist individuals with daily tasks such as bathing, dressing, meal preparation, and medication management. Additionally, home care may include medical services like wound care and physical therapy. The overarching goal of home care is to empower individuals to maintain their independence and overall quality of life, all within the familiar surroundings of their own home. This care can be provided on a short-term basis, such as during post-surgical recovery, or for extended periods to manage chronic conditions or provide elderly care.

What is the difference between home care and home health care?

Home care is a broad term that encompasses all areas of care that may support independent living for an individual inside their own home, instead of transitioning to a care home facility. Home health care is a more specific type of care that focuses on the medical concerns of a person’s care plan. Where home care may encompass anything from personal care to meal preparation, transportation support, and companionship, home health care is performed by a licensed or certified nurse or healthcare provider.

What is the role of a home care aide? 

Home care aides provide companionship and support to individuals, assisting them with daily tasks such as bathing, dressing, grooming, meal preparation, and light housekeeping, with the goal of helping them maintain their independence at home.

What is home palliative care?

Palliative home care enhances the quality of life for individuals dealing with serious illnesses by offering relief from symptoms, pain, and stress. Home palliative care encompasses symptom management, medical attention, emotional support, care coordination, and family support. Palliative care is not limited to a specific stage of illness and can be provided alongside other care options.

What is hospice care at home?

Hospice care in the home focuses on providing comfort and improving the quality of life for individuals nearing the end of their lives. This specialized care, typically for those with a prognosis of six months or less, encompasses pain management, medical care, emotional and spiritual support, personal care, and respite services for caregivers. It can be tailored to varying schedules or level of need you, or your loved one, need. Hospice care is often covered by Medicare, Medicaid, and private insurance.

Is hospice available 24/7 in one’s home?

While hospice care in Pennsylvania typically doesn’t include round-the-clock home coverage, it offers intermittent visits by a team of trained and certified healthcare professionals to deliver essential medical care, pain management, and support. Hospice services can, however, assist in arranging continuous care for short-term crises or periods of intense symptom management. For comprehensive 24-hour care, families may consider supplementing hospice services with private pay caregivers.

How much should we plan to spend on private care?

Private home care costs in Pennsylvania generally fall between $20 and $30 per hour. However, several factors can influence the final cost, including the specific region, the complexity of the care required, and whether the caregiver is agency-affiliated or independent. It’s important to note that specialized care or services from highly experienced caregivers may come at a premium rate.

What is the cost of  24/7 in-home care?

The cost of 24/7 in-home care in Pennsylvania typically falls within the range of $15,000 to $23,000 per month. However, it’s important to remember that this figure can fluctuate based on several key factors. These include the specific location within the state, the complexity of the care services required, and whether you choose to engage an agency or hire independent caregivers directly. For a more tailored and accurate estimate, we recommend reaching out to our team or individual caregivers in your area.

What is the cost of in-home care?

In Pennsylvania, the cost of in-home care varies based on the type and level of care required, as well as the specific region.

Here’s a breakdown:

• Non-medical home care: This includes help with daily activities like bathing, dressing, and meal preparation and typically costs between $20 and $30 per hour.
• Skilled home health care: This provides medical care, such as nursing and physical therapy. It usually costs more than non-medical care, averaging $30 to $50 per hour.
• 24-hour care: This can range from $15,000 to $25,000 per month, depending on the level of care needed and whether services are provided by an agency or independent caregivers.

*For exact estimates, it’s best to get quotes from local home care providers

What insurance providers cover in-home care in Pennsylvania?

Several types of insurance have coverage for in-home care services in the state of Pennsylvania:

• Medicare: Typically covers skilled nursing care, physical therapy, and other home health services for those who meet specific eligibility criteria.
• Medicaid: Offers coverage for in-home care services, usually for individuals with low income who meet eligibility requirements.
• Private Health Insurance: Coverage will vary depending on the specific policy but may cover a variety of in-home care services.
• Long-Term Care Insurance: Extra coverage designed to help with costs associated with assisted living, nursing home care, or in-home care.
• Veterans Benefits: Eligible veterans may qualify for in-home care options.

It’s always recommended to contact your insurance provider(s) in order to understand your specific coverage.

Is home health care covered by Medicare?

Medicare offers coverage for home health care in Pennsylvania when specific criteria are met. This coverage encompasses services like skilled nursing care, physical therapy, speech-language pathology, and occupational therapy. To be eligible, a doctor must certify that the patient is homebound and requires intermittent skilled care, and the care must be delivered by a Medicare-certified home health agency.

Services typically covered by Medicare include:

• Skilled nursing care (part-time or intermittent)
• Speech-language pathology services
• Medical social services
• Physical therapy
• Occupational therapy
• Part-time or intermittent home health aide services

It’s important to note that Medicare doesn’t cover round-the-clock care, meal delivery, or homemaker services if they are the sole care needed. It’s always helpful to call Medicare’s support line to find out what you are eligible for.

What qualifications are there for home health care under Medicare?

To qualify for Medicare home care in Pennsylvania, you must be certified by a doctor, require skilled nursing or therapy services, be considered homebound, and receive care from a Medicare-certified home health agency.

How long does Medicare coverage pay for nursing home care?

Medicare provides coverage for skilled nursing facility (SNF) care in Pennsylvania, but only for a limited duration and under specific circumstances. This coverage extends up to 100 days per benefit period, with Medicare fully covering the initial 20 days. However, for days 21 through 100, a daily coinsurance amount applies (set at $200 per day in 2023). It’s important to note that Medicare does not cover long-term or custodial care in a nursing home beyond this 100-day period.

What to expect when Medicare terminates payment for nursing home care?

When Medicare coverage for nursing home care in Pennsylvania ends, individuals are faced with several options: qualifying for Medicaid, covering costs out-of-pocket, utilizing long-term care insurance benefits, or seeking financial assistance from family. Given the complexities involved, seeking guidance from financial and legal advisors is highly recommended.

Can you pay for nursing home care with Social Security?

Yes! You can use Social Security to pay for nursing home care. If you’re using Social Security to pay for nursing home care in Pennsylvania, here are some strategies to consider:

• Utilize Social Security income: Your Social Security benefits can cover a portion of the nursing home costs.
• Explore Medicaid: If you meet the eligibility criteria, Medicaid may cover the remaining expenses after your Social Security benefits are applied.
• Consider Supplemental Security Income (SSI): If you require additional financial assistance, SSI can provide further support.
• Combine resources: If needed, use personal savings and contributions from family members to supplement your Social Security benefits.

Consulting with a financial advisor can provide valuable guidance on the best approach to manage these costs effectively.

Can Medicaid help pay for 24-hour home health care?

Medicaid in Pennsylvania typically does not cover 24-hour home care on an ongoing basis. However, Medicaid may cover part-time or intermittent home care services, and in some cases, more extensive in-home care through specific waiver programs designed for individuals with significant needs. These programs might provide more comprehensive support but usually not continuous 24-hour care.

For those needing 24-hour care, other options such as combining Medicaid benefits with personal funds, long-term care insurance, or other community resources might be necessary. It’s best to contact the Pennsylvania Department of Human Services or a Medicaid specialist for specific guidance and available programs.

While Medicaid in Pennsylvania doesn’t typically cover continuous 24-hour home care, it may cover part-time or intermittent services. In some cases, individuals with significant needs may qualify for more extensive care with specific waiver programs, offering support but usually not full-time coverage.

For those needing round-the-clock support, exploring additional options like combining Medicaid benefits with personal funds, long-term care insurance, or other community resources may be necessary. Contacting the Pennsylvania Department of Human Services or a Medicaid specialist can provide personalized guidance and information on available programs.

Is palliative care at home covered under Medicare coverage?

Medicare Part B covers palliative care at home in Pennsylvania, and in some cases Part A covers it if it’s part of a hospital or skilled nursing facility stay. This coverage includes visits from doctors, nurses, and social workers, symptom/ pain management, counseling and emotional support, and some medications/supplies related to the serious health condition. Patients must meet certain eligibility criteria, including having a serious illness that requires palliative care.

How much is covered for in-home care by the VA?

The VA provides a range of in-home care benefits in Pennsylvania, offering financial assistance that can span from a few hundred up to several thousand dollars monthly. For instance, the Aid and Attendance benefit can provide up to $2,229 per month for eligible single veterans. The specific amount a veteran receives is determined by their individual needs and eligibility criteria.

At what point does a person with dementia need care beyond home health care?

Determining the right time for someone with dementia to transition to a care home involves careful consideration of the aspects impacting their health, safety, and overall well-being. The capacity of family caregivers to support their evolving  needs should also be considered.

Key indicators suggesting a potential need for care home placement include: heightened safety concerns due to wandering, falls, or accidents; health needs necessitating 24/7 supervision or medical care beyond what can be provided at home; increasing physical, emotional, or financial strain on family caregivers; difficult behavioral changes such as aggression or agitation; a decline in self-care abilities despite assistance; and social isolation impacting overall well-being. Consulting with healthcare professionals can provide valuable guidance in assessing these factors and determining the most appropriate timing for a transition away from in-home care to a care home facility.

Is in-home dementia care covered by Medicare? 

Medicare does cover home health care for individuals in Pennsylvania with dementia if certain requirements are met. Covered services include: part-time or intermittent skilled nursing care; physical, occupational, and speech therapy; part-time or intermittent personal care services; and support for social and emotional needs. To qualify, the patient needs to be homebound, a doctor must certify the need for home health care, and the care services must be provided by a Medicare-certified agency. It’s important to note that Medicare does not cover custodial care or 24-hour care.

Is in-home dementia care covered by Medicare? 

Medicare does cover home health care for individuals in Pennsylvania with dementia if certain requirements are met. Covered services include: part-time or intermittent skilled nursing care; physical, occupational, and speech therapy; part-time or intermittent personal care services; and support for social and emotional needs. To qualify, the patient needs to be homebound, a doctor must certify the need for home health care, and the care services must be provided by a Medicare-certified agency. It’s important to note that Medicare does not cover custodial care or 24-hour care.

How does someone qualify for health care services?

To be eligible for home health care services in Pennsylvania, individuals must meet specific criteria: they must have a doctor’s certification of need and a corresponding care plan, be considered homebound (meaning leaving the home requires extensive assistance and effort), require intermittent skilled nursing care or therapy services, and receive care from a Medicare-certified home health agency. Meeting these requirements often qualifies an individual for home health care services covered by Medicare. It’s always good to contact Medicare directly to see what is covered in your own situation.

Who pays for hospice care at home?

Hospice care at home in Pennsylvania is often covered by private insurance, Medicaid, Medicare, or veterans’ benefits. In addition, some non-profit organizations offer free, or low-cost, hospice services based on financial need. If no other coverage is available, individuals may be required to pay for hospice care out-of-pocket.

What is the role of family members in a care plan?

Family members are a key member in any care plan and are invited to participate as much as they can. Open communication between health providers, in-home care providers, family members, and the client is vitally important to encourage continuity of care and better health outcomes.