Palm Beach, Martin and St. Lucie Counties home health care services may be covered by insurance

As many elderly and recovering individuals begin to choose to receive their healthcare services at home rather than in a hospital or nursing facility, costs are always an issue. There are also issues with neglect and the spread of illnesses throughout hospitals and nursing homes that can be avoided with home health care or private duty services, making them a better choice for some families.

The good news is that many insurance carriers do provide an option for home health care  services to be covered by the patient’s standard health insurance whereas

private duty nursing is covered by cash or Long Term Care Insurance.

What is private duty nursing?

There are now many individual healthcare practitioners and even businesses that focus solely on helping people in the comfort of their own homes, rather than going to a hospital or doctor’s appointment. This is especially beneficial for those who are very old, or people who have difficulty moving around due to certain health issues or debilitating disease. Home health care and Private Duty Nursing  agencies may hire several nurses or certified nursing assistants and send them out to homes as needed.

Who needs these services at home rather than in a facility?

According to the American Association for Long Term Care Insurance, there are several million more people with disabilities, acute illnesses, or permanent conditions who receive care at home rather than in a facility such as a nursing home. It is actually becoming much more common for people to receive necessary care at home when possible, rather than being committed to some kind of external operation filled with larger volumes of patients who do not receive as much attention.

There are a range of services available from nurses and aides who help people at home. This can include an aide who provides assistance with basic tasks like meal preparation, getting dressed, running errands, going with the patient to doctors appointments and helping the patient move around safely. Whereas a nurse practitioner administers more advanced services such as giving medications, coordinating with a primary care doctor, and drawing blood for analysis. Some people may only need help in the short term due to an injury or illness, while others may need permanent assistance.

How are the services provided?

Many home healthcare agencies hire skilled nurses after doing background checks and performing other procedures to make sure each nurse is qualified and has a clean background. The agency can then assign these nurses to homes as needed based on their background and expertise to match the needs of the patient. Agencies may provide continuous training and make sure their nurses have a license in good standing annually. As healthcare providers, these agencies also need to be recognized by the state, and they will usually have a license number or some other credentials to verify that they are legitimate. It is a good idea to check for all of these credentials when deciding on a healthcare provider that will be around your home and family consistently.

Will my coverage pay for Home Health Care and Private Duty Nursing services?

Unfortunately, there is no simple answer to this question because every health insurance company and policy is different. The good news is that many policies do cover Home Health Care services, however you will still need to check with your insurance provider.  Our office will verify your insurance benefits prior to receiving care and we will let you know if the services will be covered.  Private Duty Services will only be covered by Cash or Long Term Care insurance. There is even specific long-term care insurance that can be purchased by some individuals who are eligible prior to receiving services.

It is important to check the details of your Long Term Care Insurance.  Some plans have a specific exclusion where they will absolutely not cover private duty nursing and related services. Others may have a specific section of the benefit plan related to this kind of coverage, and the same documentation should provide more information regarding exactly what is included in the plan, and the amounts that will be covered before the policy holder has to pay out of pocket expenses.

What if my plan does not offer this kind of coverage?

It may be possible to purchase additional coverage, switch plans, or pay for the services directly. While health insurance is an important matter, if someone expects to receive long term care at home, it may be a good idea to look into adding a Long Term Care policy as this will be valuable to receiving Private Duty Services in the future.

It is also important to secure some kind of relevant coverage sooner rather than later, as healthcare costs for private services, and in general, are expected to increase greatly in the coming years and decades. This means that healthcare may be financially out of reach for those who do no already have the proper insurance.

What accounts for the costs?

A significant amount of the cost related to private duty services is paying for skilled nursing. The nurses need to be paid a comparable rate to what they would receive in a hospital or nursing home for their time.

Get in touch with the best Home Healthcare and Private Duty Nursing Agency provider near you

If you have any questions about receiving home health care or Private Duty Nursing services for yourself or a relative, contact First at Home. The staff who work for First at Home provide quality care within the Palm Beach, Martin and St. Lucie County areas.