Paying For Home Health Care

Most health insurance providers cover at least some cost of home care treatment because home health care is typically much less expensive than hospital treatment.

Coverage for acute (short term) medical needs are generally covered.Coverage for long-term care varies greatly from plan to plan. Check your plan or contact your benefits administrator for the specific details of coverage.

If home health care, or a specific home service is not covered by your plan, there is still a possibility of getting the company to pay. You, or someone acting on your behalf, may be able to convince your insurance provider to pay if you can show that the cost of home care will save the company money. Insurance companies are concerned about the high cost of medical care, and are increasingly willing to reimburse for optional services that can be demonstrated to be appropriate, cost-effective alternatives to hospitalization. The argument regarding cost effectiveness of home health care is generally an easy one to make.

Before contacting the insurer:

• Get from your doctor in writing:
  • Confirmation that you need medical care in your home.
  • What services will be required.
  • What type of health care professional is needed to provide each service.
  • How often the services will be required.
• Work with a health care agency to put together plan which will show how much it will cost the company per week or per month. The plan doesn't have to be to the penny, but should be within a reasonable range. Be sure that the costs are verifiable - for instance, that costs do not include cash payments for which there will not be any receipts.

When you call the insurer, speak with a supervisor or other person who has decision making authority.

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