Understanding What’s Covered—and What’s Not
When a loved one needs support at home, one of the first questions families ask is, “Will Medicare or insurance pay for this?”
The answer depends on the type of care your loved one needs. Understanding the difference between medical and non-medical home care is the key to avoiding confusion and planning ahead.
At Felly’s Home Care, we specialize in non-medical home care that keeps clients safe, independent, and comfortable at home. Let’s take a closer look at how coverage works.
1. Medicare and Home Care
Medicare is designed to cover skilled medical care, such as nursing, physical therapy, or wound care—usually provided by a home health agency after a hospital stay.
That means Medicare will not cover:
- Companionship or social visits
- Help with personal care like bathing or dressing
- Light housekeeping, meal prep, or transportation
These services fall under non-medical home care, which is considered custodial rather than medical.
However, you can combine Medicare-approved home health care with private non-medical care for a more complete solution—especially during recovery or chronic conditions.
2. Medicaid Programs and Home Care
For eligible individuals, Medicaid may help cover some in-home services through special state programs or waivers.
In New York, programs such as the Consumer Directed Personal Assistance Program (CDPAP) allow family members or chosen caregivers to be paid for providing care. Requirements vary, so it’s best to contact your local Department of Social Services to confirm eligibility and application steps.
Felly’s Home Care can help connect you with local agencies to explore available benefits in Dutchess, Ulster, or Putnam Counties.
3. Long-Term Care Insurance
If your loved one has a long-term care (LTC) policy, this is often the best way to cover non-medical home care costs.
Most LTC policies reimburse for:
- Assistance with activities of daily living (ADLs)
- Homemaking and companionship services
- Respite care for family caregivers
Be sure to review the policy’s elimination period, coverage limits, and reimbursement process. Our team can help you gather the documentation insurance companies typically require.
4. Veterans’ Benefits
Veterans and surviving spouses may qualify for the VA Aid and Attendance benefit—a monthly stipend that can offset home care costs.
This program can make a meaningful difference for seniors who want to remain at home with the support they deserve.
5. When Insurance Doesn’t Cover Everything
If your family’s coverage doesn’t fully include non-medical care, don’t worry. Many families combine private pay with part-time schedules to manage costs effectively. Even a few hours of weekly support can greatly improve safety and peace of mind.
At Felly’s Home Care, we’ll help you design a customized care plan that fits your needs, schedule, and budget—without surprise charges.
Get Clarity Before You Begin Care
Every insurance plan is different, and navigating benefits can be confusing. Our team is here to make it simple.
We’ll explain your options, review coverage possibilities, and help you start care as soon as possible.
👉 Contact Us for Guidance and a Free Consultation
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Felly’s Home Care can guide you through payment options and local programs that may help offset costs.
