Insurance

There isn’t any insurance called assisted living insurance, companion care insurance or case management insurance. All of these insurances are usually referred to as long term care insurance. Generally speaking Medicare, Medi-Cal and most healthcare insurance plans do not cover any of these services. A comprehensive long term care insurance policy will cover care in an assisted living facility, companion care and case management services.  There are dozens of companies that sell comprehensive long term care insurance:  John Hancock, Metropolitan Life, Unum Provident, GE, Prudential are just a few that offer it. If not, try to work with an independent agent (see our preferred provider list) who specializes in long term care insurance.  He/she will know the companies, the differences in their policies and be able to help you choose the best policy to meet your needs. All of our businesses are familiar with billing long-term care insurance policies. It is important that you research the company that will provide services to your loved one, there are many technical requirements in billing this type of insurance.

Home Healthcare — Home care services can be paid for by:

  • patient and family (out of pocket)
  • public third-party payers such as Medicare, Medicaid, and the Veterans Administration (VA)
  • private third-party payers such as health insurance companies and managed care plans

For most home care to be covered by public and private payers it must be considered medically necessary. You must also meet certain coverage requirements. Different private insurance plans have different policies, and you may need to call them to find out about what they cover. Medi-cal coverage and eligibility is based on the California requirements.

For services that are not covered by insurance, you may choose to pay out of your own pocket if you can afford it. Some agencies get money from community groups or local and state governments to help patients pay for their care when they have no other way to get it. Some agencies get donations from individuals and charity groups so they can provide care to anyone who needs it, whether or not they are able to pay. Around the Clock Home Healthcare accepts most managed care and third-party insurances.