Does health insurance pay for home care, or is it primarily paid for out of pocket by family members or those in need of assistance?

I applied for Aids and Attendance in Sept. After over six months, Mom was turned down because...she made 20K a year and they only allow 13k for a surviving spouse. My Mom was paying 4500 a month for an AL. Didn't appeal since I knew Mom was going on Medicaid.
Does this woman have family? If so, they should be helping her. If not, she needs to call her supplemental insurance to see if an aide is covered. If not, Medicaid can be called in to evaluate for one but she is going to have to prove her finances. Office of Aging can also evaluate for an aide. In the meantime does she need a shower chair? A handheld shower head. Rails in the tub. You can get suction cup kind that I personally had no problem with.

The only type of insurance we know that covers non-medical home care (personal care, companionship, errands) is Long-term care insurance and even that requires a grace period where you will have to pay out of pocket usually 30-90 days.

For more affordable options, I would check with your care manager because there are options for Veterans, Social Security and other low-income.

I would suggest contacting the local Eldercare agency in your area and discuss best options.
Medicare insurance may cover a few hours a week of a home aide for bathing and light home assistance. If daily help is needed, the coverage tends to be inadequate.
If your friend qualifies for Medicaid, there are programs which can provide in home aides. However, funding is limited and there is often a waiting list.
I ultimately hired an eldercare expert to help. Spending money to get help getting money for my Dad seemed counterintuitive to me, but it was very worth it in the end. Within 2 months, he was qualified for Medicaid, then qualified for a program that paid for an in-home caregiver 30 hrs/week. I appealed based on his need, and it was increased to 56 hrs/week.

Kay,

I may have read it wrong but I understood the $2000 per month to be a income based benefit where the total income/benefit is $2000/mo. So, if your SSI is $1995/mo, you would only get $5 per month.

Insurance per se does not cover home care. What Medicare covers is next to nothing. If not a vet, then out of pocket or some sort of public benefit are the remaining alternatives. This will likely start with an in-home assessment & go from there.

If this person was in the military and is a veteran there is a veterans benefit or if the spouse of a veteran called aid and assistance. If you can provide almost 2000 Per month if you follow the instructions on how to apply for it at your local VA office. However you'll find that $2000 goes quickly at the in-home care rates and depending on what type of care they need .there's a website called Veterancare.org or something like that you might want to research if the person is a veteran. Or you can research the topic on this website where it is discussed indepth -veterans assistance. Good luck with your journey.

Medicare does pay for limited home care. My mom was receiving both physical therapy and skilled nursing services at home through Medicare. However, the number of hours and services is very limited. If more care than that is needed, the can apply for Medicaid, which will provide home health care, including an aide for companion/personal services. There is also something called the Veteran's Aid and Attendance benefit. If the person or their spouse was in the military for 90 days or more and served at least one day during war time, they may be eligible for this benefit. It provides money for home care or assisted living. However, there are more eligibility criteria and I have heard it takes quite some time to get.

If your parents had purchased long term in-home insurance policy...then it would be available now.

But...you can't purchase the policy only when you need it! Many of those policies have no benefits in the first 5 years...and then a sliding scale each year after.

My parents bought such a policy in 2000. They both started collecting benefits in 2016. It is a decent policy...but 16 years of paying more than $600 a month was the price!

VaVolunteer, my parents also paid out of pocket for home care.  Their accountant was able to deduct some cost on income taxes.

If your friend can qualify for Medicaid [which is different from Medicare] the State might have a program where they could send out an Aide for a few hours per week, but in your friend's case sounds like he/she needs much more care than that. Some States might pay you to be that person's caregiver, but the pay would be minimum with long hours.

Depending on the degree of care your elder friend needs, Medicaid might suggest a skilled nursing home who Medicaid would foot the bill. Now if your friend owns a house, a lien would be placed by Medicaid so that they could receive some type of reimbursement.

As for the family paying, only as a last resort.  The family shouldn't need to drain their own retirement funds when Medicaid is available.

My Mom had end stage dementia. She was on Medicare. Medical insurance did not pay for home care. We paid out of pocket for PCAs from a homecare facility to stay with her nights so we could catch up on sleep. Medicare did however pay for Hospice care and supplies.

Can you tell me what types of supplemental insurance would assist with payment?

Mom was on Medicare and had supplemental insurance. We paid for caregivers out of pocket.