Shirilevita

There are a number of ways to pay for different kinds of home care and some people are able to combine more than one method. Costs for different services range from the inexpensive to very costly, but are almost always less than hospital or nursing home costs. The following forms of payment are most likely to apply if you or a family member are over 65:
Medicare can be used by everyone over 65 and by certain disabled persons under 65. It pays for part-time skilled nursing, physical therapy, and speech therapy. If any one of these three services is used, Medicare sometimes pays for limited amounts of needed part-time homemaker/home health aide services, medical social services, occupational therapy and some medical supplies and equipment. All of these services must be ordered by a physician and all services must be provided by a certified home health agency. New rules affecting the scope of Medicare coverage are currently being worked out. To get this and other information about Medicare, call your local social security office.
Medicaid is designed for low-income people of all ages. It is administered by each of the fifty states, so that rules for coverage vary somewhat from one to another. Medicaid covers a number of expenses not included under Medicare. Rules and benefits under Medicaid may also be changing in the near future. Your local social security office can give you further information, as can your city or county Department of Social Services.
Private health insurance through nonprofit companies such as Blue Cross/Blue Shield (and through some of the commercial insurers), covers certain home care services. Not all policies spell these provisions out. Contact the insurer to find out exactly what your policy includes in the way of health-related home care. You may be able to combine private insurance and Medicare or Medicaid to obtain the range of services you need.
Health Maintenance Organizations (HMOs) often include some types of home care in their health care packages. If you belong to a prepaid health plan, you should, again, inquire specifically as well as re-read your contract carefully.
Title XX (Twenty) of the Social Security Act as well as certain provisions of the Older Americans Act of 1965 may help support homemaker/home health aide services for some low-income older people. As before, your local social security office or State Office on Aging can supply fuller information.
Self payment—out-of-pocket expenses for some types of home care (home nursing, special equipment and transportation to health centers)—may be tax deductible, whether you are paying for yourself or someone else. (The other person need not be your dependent.) IRS publication 502, “Medical and Dental Expenses,” explains further, or you can call your local Internal Revenue Service office—preferably not near the April 15th tax deadline.

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