Whose Pocket Will Pay for Home Health Care?

Industry ReportThe demand for home health care has risen as insurers have driven down the length of hospital stays. “Often [patients] are going home and they are still at a very acute phase of their illness,” says Melissa Burnside, managed-care division director for Bayada Nurses. “Insurance companies are often willing to authorize home care because the patient can go home sooner and home care is less expensive than a hospital stay,” she says.

Moorestown-based Bayada Nurses has 9,596 home-health workers in the field, including nurses and aides, an increase of 354% in the last 10 years; in 1996, there were 2,706 people in the field, says Melissa Burnside, division director. The company has been in the home-health services business for 31 years.

Of course, not everyone has insurance that will cover all or part of their home-care costs. Some may have to dip into savings or use their credit cards to handle the bills that Burnside says can range from $22 per hour for an aide to $50 per hour for a skilled nurse, depending upon what services the patient needs and where he or she lives. Care in the Northeast is more expensive than other areas of the country because of the increased costs of living, Burnside says.

Burnside says insurance can come into play under various circumstances. Workers’ compensation may pay for the treatment of work-related injuries; auto insurance cover care for accident-related injuries and sometimes, regular health insurance plans sometimes kick in as well.

“One thing we have seen in the last few years is long-term care insurance, which is particularly helpful to the seniors,” she says. Long-term care insurance may be available for purchase before illness or disability strikes to cover the cost of custodial-care services, which are not typically covered by other types of commercial insurance, she says. For example, long-term policies may pay for a home health aide to come to the home and assist with personal care, such as bathing, dressing and meals. “Other than private pay, the elderly don’t have an option to get that kind of service otherwise,” she says. “It’s the insurance that covers the custodial services that are needed by the elderly and disabled.”

The use of these policies is on the rise, says Burnside,who learned about them 10 years ago. “It’s only in the past few years we have seen people who bought these policies use them.” The downside with long-term care policies, she says, is that they are expensive.

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