For anyone who has never worked with home care agencies, it’s easy to assume that there’s little or no difference between them. After all, don’t they all have to be regulated in some way or offer the same type of services for clients? Nothing could be further from the truth!
There are often wide variances in the quality of care and types of services available, as well as whether the care offered is reimbursable by Medicare or other insurance so it pays to know what to look for as well as asking the right questions when choosing a home care agency.
Home care or home health care – there is a difference
First, it’s important to clarify that home care, while often used interchangeably with home health care, is not the same thing – as Medicare and most insurers make clear. Home care has far fewer regulations governing it, and is not payable through Medicare, (although some long term care (LTC) insurance policies will cover it as well as Medicaid for those meeting financial criteria.) Home health care is a higher level of care and is not only regulated at both the federal and state levels but is payable through Medicare and most long term care (LTC) insurance policies.
Here’s a breakdown of the main differences between the two types of care:
- Does not have to be prescribed by a doctor, except if using Medicare or LTC insurance
- Helps with activities of daily living (ADLs)
- Does not normally require a minimum skill set, licensing or training level by the provider
- Caregivers can remind the patient to take their medicine but may not administer medication to the client
- Caregivers can perform light housework and meal preparation
- Caregivers can provide transportation to and from appointments, shopping, etc.
Home health care:
- Physician-prescribed (considered medically necessary for recipient to be cared for in the home)
- Skilled or semi-skilled care provided by trained and certified or licensed personnel, such as certified nurse’s aides (CNAs) and nurses
- Can offer specialized caregiving, such as rehabilitation care
- Are able to legally administer medication
- Assist with ADL tasks
Is there a difference in cost?
In-home care costs averaged around $3,800 for 44 hours of care in 2016; whereas basic assisted-living facility care averaged somewhat below that - $3,628 for a month, but can vary depending on what part of the country one lives in as well as required provider skills and services rendered. Keep in mind that additional services, such as bill-paying, respite care, record keeping or adult day care can add even more to a patient’s monthly costs, usually as much as $500 to $1,000 per month above and beyond the normal routine care provided. These costs normally are charged by home health care companies, rather than basic home care agencies, and are usually not covered charges.
Medicare has an excellent checklist on their website for evaluating home care and health care agencies as well as payment information. Once you know the differences between the two types of in-home care, it’s easier to plan your finances accordingly by requesting only the care needed.
In-home care prolongs independence for the elderly
For those who don’t need medically-related health care services, having a home care provider (or “home care aide” or “personal care aide”) help with some personal care or household chores may be an ideal solution for many otherwise-independent seniors. Shopping, laundry, providing transportation and meal preparation are a few of the ways home care agencies can safely keep the elderly in their homes while extending their independence and dignity.