Which is the #1 best insurance for in home care, you may be surprised.

People who need in home care, or assisted living, often wonder what’s the #1 best insurance for in home care.  The answer is not Medicare or the typical commercial insurance employees get at work.  The #1 best insurance for in home care is long term care insurance.

What kind of in home care does Medicare Cover?

Medicare and traditional commercial health insurance policies will pay for home health visits of a nurse, physical or occupational therapist after a hospital or skilled nursing facility stay.  However, that care is intermittent, up to an hour, and lasts for 1 to 2 months.

The #1 best insurance option for in home care is Long Term Care Insurance

Long term care insurance is a different type of best insurance for in home care, policies that are purchased long before the care is needed and are triggered by an accident or illness.   This is the #1 best insurance for in home care because it covers “shift” care, not just visits. Most seniors want shifts of three to four hours with help as they age, a visit of an hour once a week won’t typically meet their needs.

Seniors exploring the #1 best insurance for in home care
Senior couple researching the #1 best insurance for in home care

Unlike life insurance, which has been around for more than 200 years, long term care insurance is a relatively new concept. Long term care insurance has been around since 1974. The price people pay for it is based on many factors, such as their age, whether they have an underlying health condition, family history and history of smoking, or alcohol or drug abuse.

It was started by GE and now is sold by brands such as Genworth, Transamerica, John Hancock and more. 

Long Term Care is the #1 best insurance for in home care
Doctor holding a card with text LONG TERM CARE in both hands. Medical concept,

How to Start a Long Term Care Claim

Typically to trigger coverage, a person must need one of two things:

  1. Constant safety management due to cognitive impairment, such as Alzheimer’s disease or dementia or
  2. Help with two to three activities of daily living (ADL’s), such as bathing, dressing, transferring or toileting.

General weakness associated with aging may trigger a need for stand by assistance when a senior bathes, or assistance with putting on clothing or shoes, or help getting from a chair up to walking or from walking to lying down in bed. Those conditions would trigger coverage under most long term care policies. Other conditions that might trigger coverage is an injury from an accident or fall, such as a broken hip, cancer, Parkinson’s or other ailments that challenge mobility.

Needing ambulation is one of the triggers for the #1 best insurance for in home care
Caregiver helps a senior man with ambulation, one of the triggering needs for the #1 best insurance for in home care

Each policy is different, and policy holders should read their policy for specific rules on how to trigger a claim.  At Home Nursing Care works with dozens of long term care insurance companies and can help clients review their policies, open claims and bill accurately.

People who do not have this #1 best insurance for in home care should not expect to rely on Medicare or their traditional health insurance, and that can come as a shock when the need arises.  The same is true for assisted living residences, those are mostly paid privately, out of pocket from the seniors or their families. 

What other benefits cover in home care?

There are other benefits that may help pay for the cost of in home care, such as VA benefits for those who qualify.   Medi-Cal offers some waiver programs to help Medicare recipients get some in home care covered by the state. 

Very low-income adults, who are not property owners and who have small balances in their bank accounts, may get coverage through the IHSS system, or In Home Supportive Services program.   That is run by the state typically through county offices. Low-income seniors are authorized a certain number of hours for that in home care, and the caregivers are paid by the county.

The cost of in home care matters with or without the #1 best insurance for in home care.  Hourly rates vary based on location, type of care provided and the length of the shift.  Most in home care agencies charge between $38-45 hourly for in home care in Southern California, making budgeting and planning for those costs, which have risen steadily over the years, a priority even for younger adults.