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  • Michelle Varela


In Home Long Term Care

Cost: The average cost of in-home care in the United States is $4,957 a month. Costs will vary by location and by service level.

Under the umbrella of in-home care, there are several different types of assistance and different roles of those who deliver these services. The type of care one needs will depend on their health, abilities, and budget.

Home-based care includes health, personal, and support services to help people stay at home and live as independently as possible. Most long-term care is provided in the home of the person receiving services or at a family member's home. In-home services may be short-term—for someone who is recovering from an operation, for example—or long-term, for people who need ongoing help.

Most home-based services involve personal care, such as help with bathing, dressing, taking medications, and supervision to make sure a person is safe. Unpaid family members, partners, friends, and neighbors provide most of this type of care.

Paid caregivers, including caregivers found informally, and healthcare professionals such as nurses, home health care aides, and therapists who are hired through home health care agencies can provide home-based long-term care services.

Home health care can also involve part-time medical services ordered by a physician for a specific condition. These services may include nursing care to help a person recover from surgery, an accident, or illness. Home health care may also include physical, occupational, or speech therapy and temporary home health aide services. These services should be provided by home health care agencies approved by Medicare, a government insurance program for people over age 65.

Types of Home Health Care

Companion Care Services

Companion care services are ideal for seniors who live independently and do not need much assistance with their activities of daily living. Companion Care services may include spending time with the client by read to them, participating in the client’s hobbies, or providing supervision. An elder companion may also provide transportation services and assist in medication management. Typically, companion care aides are not certified to administer medications or otherwise provide any type of medical care.

Personal Care Assistant

Personal care assistance is ideal for seniors who need regular help with their activities of daily living. Personal care assistants can provide a broad range of services, including help bathing and toileting, grocery shopping, and mobility assistance to prevent falls. These aides may not provide any medical care beyond medication management. This type of home care is comparable to the services residents receive in assisted living communities. Therefore, personal care assistants can certainly provide help to make the client’s life easier and safer. However, this level of care is not suited for someone who requires medical care of any type.

Home Health Care

Home health care aides carry certification to provide medical assistance. Unlike standard home care, which a senior or their family can seek out when they feel the time is right for them, home health care is typically recommended by a physician and may require a doctor’s written order to have the services covered by insurance. Seniors who require frequent medical services, such as injections or infusions, can work with a home health care provider on a regular basis. Others may seek home health care on a short-term or as-needed basis, such as when recovering from an injury or surgery. The range of services that one can receive from a home health aide is similar to what one would receive in a nursing home.

Finding the Right Home Care Services

Full-service agencies usually come at a higher cost but provide prescreened applicants who have already had background checks. Since the caregiver works for the agency, they take care of billing and tax issues. They may also be bonded for issues such as theft. If a caregiver quits or is not working out, an agency can usually find a replacement quickly, and may provide coverage if a caregiver calls in sick. Independent providers usually come at a lower cost, but require more legwork on your part. You will need to handle any tax requirements and perform background checks and identity verification. In the case of illness or sudden termination, you’ll also be responsible for finding a replacement provider.

Who is a Good Fit for Home Care?

Home care oftentimes serves as an alternative to assisted living for seniors who wish to live independently. It can be a good care option for those who meet the following criteria.

  • Seniors who struggle with mobility and need assistance safely moving throughout their home

  • Seniors with impaired motor skills who need assistance with daily household tasks

  • Seniors who no longer drive and need transportation to appointments, the grocery store, friends’ houses, and more

  • Seniors who are isolated and desire the companionship of a caregiver

  • Seniors who need assistance with ADLs including meal preparation, bathing, and more

  • Seniors in need of housekeeping services such as cleaning and grocery shopping

  • Seniors in the early stages of memory impairment

Cost of Home Health Care

The average cost of in-home care in the United States is $4,957 a month. Costs will vary by location and by service level. For home health care, the cost is higher, at an average of $5,148 a month. However, considering that home health care can include nursing services, it is a more economical option than residential skilled nursing care, which costs an average of $7,908 a month for a shared room and $9,034 for a private room.

The national median cost of personal care services provided by a home health aide is $28 per hour according to Genworth's most recent Cost of Care Survey. The median hourly cost of nonmedical home care is $26 per hour. Agencies typically charge 20 percent to 30 percent more than individual caregivers, but reputable agencies conduct background checks of caregivers and may be better equipped to provide all types of care an individual requires.

Paying For Home Health Care

Medicare Advantage Home Care Services Beginning in 2019, for the first time, Medicare Advantage benefits include non-skilled home care services. These services include benefits such as transportation to doctors’ offices or help shopping for healthier food. The new benefits may not require a physician’s prescription, but a licensed healthcare provider must designate them as medically appropriate.


Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance) cover eligible home health services like these: Part-time or "intermittent" skilled nursing care. Physical therapy. Occupational therapy. Medicare defines home health care as a wide range of health care services that can be given in your home for an illness or injury. Home health care is usually less expensive, more convenient, than and just as effective as care you get in a hospital or skilled nursing facility. The type of care refers to care provided in the home by a licensed medical professional, such as a nurse or physical therapist.

Long-Term Care Insurance

Since individuals who require non-medical home care are not sick in the traditional sense, traditional health insurance, Medicare and Medicaid may not provide for their needs. Having a Long-Term Care Insurance policy in place prior to any major changes in the health and mobility can guarantees that they will have complete home care coverage assistance available if and when they need it.

Veterans Benefits

Veteran Aid & Attendance offers families and individuals an additional method of meeting home care costs. A veteran's and their spouse's joint, countable income must be less than the pension amount for which they are eligible. For example, a married veteran in 2021 is eligible for $27,549 in A&A pension; if their countable income is $10,000, then they are eligible to receive an additional $17,549 / year in pension.

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