Who Pays

Who Pays for Home Care?

Home Care is paid for by a variety of sources. Benefits and requirements vary greatly. Major home care payment sources include:

  • Patient/Private Pay Home care services can be personally paid. The scope of services and the charges are negotiated between the patient/family and the agency. For those whose resources do not cover home care, some home care agencies offer a sliding-scale fee schedule so that a family need only pay what it can afford.
  • Private Health Insurance including Health Maintenance Organizations (HMOs) Policy coverage varies. Generally, private insurance coverage is limited to physician-directed medical services and equipment. The patient and family should check with their insurance agent to determine coverage specifics.
  • Medicare The patient must be under a physician's plan of care, homebound and in need of part-time or intermittent skilled nursing care or occupational/physical/speech therapy. Medicare beneficiaries may receive a range of services which include skilled nursing, home care aide, speech and occupational therapy, medical social work and medical supplies/equipment.
  • Medicaid (Medi-Cal in California) This federal/state administered medical assistance program provides services similar to Medicare for low-income people. No prior hospitalization or "skilled" level of service is required to qualify. Individuals do not need to be homebound.
  • Workers' Compensation Any person needing home care services as a result of an injury on the job is eligible. Workers' compensation representatives have information on eligibility.
  • CHAMPUS On a cost-shared basis this program covers skilled nursing care and other professional medical home care for dependents of active military personnel, retirees and their dependents and survivors.

 California Association for Health Services at Home
 3780 Rosin Court, Suite 150 | Sacramento, CA 95834
 Phone 916.641.5795 | Fax: 916.641.5881

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