More than 12 million Americans receive home care each year, with that number projected to climb as our population grows older and people are discharged from hospitals quicker and sicker. So what exactly is home care and who does it serve?

Home care is specialized health and social services provided to individuals where they live, keeping them safe and independent in the comfort of their own homes. Recipients often include older Americans, children and adults of any age who are disabled or recuperating from injury, and the chronically or terminally ill.

Services can meet a broad scope of needs such as ongoing medical, nursing, social or therapeutic treatments, and assistance with essential daily activities like bathing, toileting, and eating.

Personal care and companionship 

Help at home with everyday activities like bathing and dressing, meal preparation, and household tasks to enable independence and safety.

Personal Care and Companionship does not need to be prescribed by a doctor unless you are receiving it through a state Medicaid program, such as the Personal Care Assistant (PCA) program in NJ or the Personal Assistant Services (PAS) program in PA. Care is provided on an ongoing basis, on a schedule that meets a client’s needs, up to 24 hours a day, 7 days a week, including possible live-in care.

Private duty nursing care 

Long-term, hourly nursing care at home by RNs and LPNs for adults and children with a chronic illness, injury, or disability. 

Private Duty Nursing Care needs to be prescribed by a doctor. Care is provided hourly on an ongoing basis by RNs and LPNs based on the client’s needs, up to 24 hours a day, 7 days a week.

Home health care

Short-term, Medicare-certified physician-directed care designed to help a patient prevent or recover from an illness, injury, or hospital stay

Home Health Care needs to be prescribed by a doctor. Care is provided through Medicare certified visits from nurses or therapists that last up to an hour, on a short-term basis until individual goals are met.

For more information visit hcaoa.org. 

Home care enables a person to live as independently as possible without having to give up the comforts of their own home. It allows them to be in a familiar environment, sleep in their own bed at night, and stay close to loved ones like family, friends, and pets. It also brings peace of mind to know they have access to skilled, consistent, reliable care when it’s needed, even if those needs change.

When compared to other alternatives of care, home care can be significantly more cost effective. According to the Centers for Medicare and Medicaid Services (CMS), at-home care is usually less expensive, more convenient, and effective.

Personal care and companionship 

Usually paid directly by the person receiving care (private pay), or through long-term care insurance or Medicaid.

Private duty nursing care

Private duty nursing can be paid through a variety of sources, including:

1. Medicaid (with qualifications)
2. Health insurance
3. Workers’ compensation
4. Veterans benefits
5. Direct payment by person receiving care (private pay).

Home health care

When specific qualifications are met (generally, when services are ordered by a physician and a clinical assessment deems them necessary), these services are typically paid for by Medicare or private insurance.

No. Home care services can be provided wherever home is—a private residence, a senior living community, or while staying with a friend or family caregiver.

Medicare

Medicare is federal health insurance for people 65 or older, and some people under 65 with certain disabilities or conditions. A federal agency called the Centers for Medicare & Medicaid Services (CMS) runs Medicare. Because it’s a federal program, Medicare has set standards for costs and coverage. This means a person’s Medicare coverage will be the same no matter what state they live in. People with Medicare pay part of the costs through things like monthly premiums for medical and drug coverage, deductibles and coinsurance.

Medicaid

Medicaid is a joint federal and state program that helps cover medical costs for some people with limited income and resources. The federal government has general rules that all state Medicaid programs must follow, but each state runs its own program. This means eligibility requirements and benefits can vary from state to state. Medicaid offers benefits that Medicare doesn’t normally cover, like nursing home care and personal care services. People with Medicaid usually don’t pay anything for covered medical expenses but may owe a small co-payment for some items or services.