Home Care Costs and Services

Yesterday, we went over some of the questions you might ask as you check out home health care services agencies and home health aides, focusing on the qualifications of such agencies and their employees.  We also addressed the quality of the care they offer and how to gauge it.  Today, we consider the cost of such services and also look into the delivery of the actual services themselves.

Understanding in-home care costs

When considering using a home health care services agency, think about the following:

  • Will agency fees by covered by my health insurance or Medicare?  Before you sign anything, find out what payment arrangements are in place for your specific health insurance plans.
  • How are expenses and billing handled by the agency? Request, and read carefully, any agency literature explaining all their services and fees.  You will also want explicit and detailed explanations of all costs and fees associated with their home care services.
  • Does the agency provide any resources for financial assistance?  Is there a payment plan, for example?  Are any community resources available?
When considering a home health aide
  • Exactly how much does the health aide charge for home health care services?  Are the services the ones you need?  Are you comfortable with the fees?  
  • How do sick days or vacation days and holidays work?  Are you required to pay for these days?  If payment is required for sick days or holidays, be sure you understand how many such days are allowed.  And understand, too, exactly which days are considered to be holidays.  
Understanding in-home care services
As you think about using a home health care services agency or hiring a home health aide, ask the following questions about their services:
  • When can services begin?
  • Will you receive a ‘patient’s bill of rights’ – a list of the rights and responsibilities of all involved parties?
  • Will you receive a written plan of care before the services begin?  Your care plan should contain input from your doctors (or your loved one’s doctors) and include all details about your specific care needs and any medical equipment requirements; it should be frequently updated.
  • What about referrals for therapists, dietitians, counselors or other specialists?  Will such referrals be made if needed?  How is this coordinated?
  • Is it necessary to name a primary family caregiver?  If yes, what is required and expected of that person?
  • Will the agency work directly with you or your loved one?  How about with other family members?  Other health care providers?
  • What, if any, are the limits on the types of services or tasks performed?
  • When will the services be provided?  Is around-the-clock care available, if needed?
  • What emergency procedures are in place?  What happens during a power failure or a hurricane or other natural disaster?  How will the agency or aide deliver services under those conditions?
  • How does problem solving work?  Who do you or a family member go to with complaints or questions?
Once you’ve made your choices, you should be able to relax a bit and enjoy better, safer care.  But a word of caution, here.  No  matter how grand the reputation of the agency, no matter how sweet and caring the aides, you will need to monitor the situation carefully.  Any concerns or worries about any aspect of the care should prompt an immediate discussion with the agency or the aide, or both.  Is an aide showing up later and later each time?  Are you not sure the doctor’s orders are being carried out as described?  Get on the phone.  Get your doctors involved if you need to.  Sometimes we get a little timid or are afraid of  hurting someone’s feelings, but this is not the time or place for reticence. You can be lovely and polite about it, but be firm.  


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