When a loved one needs ongoing care at home, whether that is a few hours of help each week or live-in care, a lot runs through your mind at once. You want them to have the home care they deserve, and one of the first questions families ask us is the same every time: how do we pay for it?
For many families in Maryland, the financial side of arranging home care feels like a puzzle with too many pieces. The good news is that there is usually more than one way to pay, and the right answer depends on the kind of care your loved one needs. Here are the four options we walk families through most often, plus one common misunderstanding worth clearing up first.
A Quick Note About Medicare
Medicare is usually the first thing families think of, so it helps to know this up front: Medicare does not pay for ongoing, long-term home care such as help with bathing, dressing, meals, or a live-in caregiver. It may cover short-term, intermittent skilled visits after a hospital stay through a Medicare-certified home health agency, but that is a different service from the day-to-day care described below. The four options that follow are the ones that actually pay for ongoing home care in Maryland.
Medicaid Waiver and Community First Choice
Maryland Medicaid pays for in-home personal assistance through Community First Choice and the Community Options Waiver. Having a Medicaid card does not mean these services start automatically. Your loved one must qualify financially, and a nurse assessment arranged through the local health department determines how many hours of care are approved each week.
Two things families should know. First, Medicaid covers scheduled hourly aide care, not live-in care, so the approved hours set the schedule. Second, care is provided by an agency that is enrolled with Maryland Medicaid. Agatha Home Health LLC is an enrolled Medicaid provider for personal assistance services, and we can help you understand where to start the application and what to expect from the assessment.
VA Benefits
Did you know that many veterans can receive home care at no cost to them? Through VA Community Care, a veteran’s VA medical center can authorize homemaker and home health aide hours, and the agency bills the VA directly. There is no bill to the family for the authorized hours. Agatha Home Health LLC is a VA Community Care provider, and we serve veterans across Southern Maryland and Prince George’s County through this program. If your loved one is a veteran, ask their VA primary care team or social worker about a referral for home care.
Separately, certain veterans and surviving spouses may qualify for the VA Aid and Attendance pension benefit. That benefit is paid to the veteran, not to the agency, and many families use it toward private pay care. Eligibility depends on service history, the need for help with everyday activities, and financial qualifications.
Long-Term Care Insurance
A long-term care insurance policy, even one purchased many years ago, can help pay for home care once your loved one needs regular help with daily activities. Most policies begin paying when a person needs hands-on assistance with two or more activities of daily living, such as bathing, dressing, or transferring, or has a cognitive impairment like dementia.
Having a policy does not mean every home care service is automatically covered. Policies differ in their daily benefit, waiting period, and whether they cover live-in care, and most require care notes and invoices from a licensed agency. Check your policy’s terms, and ask your agency for help. At Agatha Home Health LLC, we provide the documentation insurers ask for and help families get claims started.
Private Pay
Sometimes private pay simply makes the most sense. It is the most flexible way to arrange care, with no program rules about how many hours are approved or what the caregiver may help with, and it is the most common way families pay for live-in care and 24/7 care.
Many families in Maryland use retirement income, savings, or contributions from family members, sometimes combined with a long-term care policy or Aid and Attendance benefit. With private pay, you set the schedule with the agency directly, care can usually begin quickly, and you receive a clear weekly invoice from the care provider.
Reach Out to Us to Learn More
Home care looks different for everyone, and there is no single payment strategy that works for every household. Many families end up combining options, such as Medicaid hours during the week with private pay on weekends.
At Agatha Home Health LLC, we understand that families need practical information when considering home care. Our family-owned agency was founded in 2019, and our team includes experienced home health aides and nurses. We are licensed by the Maryland Office of Health Care Quality, and we help families understand home care and live-in care services in Baltimore, Washington, D.C., Upper Marlboro, La Plata, Potomac, Waldorf, MD, and the surrounding areas.
Arranging care comes with questions about costs, coverage, and the level of assistance a loved one needs, and we are glad to walk through them with you. If you are ready to discuss home care, we are ready to discuss your family’s needs. Contact us today or call 301-932-CARE (2273) to get your questions answered.