How to pay for Jefferson County and Crystal City home health care
How Do I Pay for Home Care?
We are here to provide solutions
We recognize that one of your first questions is likely about how home care funding works. We are ready to explain the various funding options available and assist you in identifying all potential sources of funding. Our goal is to qualify you for every eligible option before you need to pay out-of-pocket.
We accept any form of funding, which includes government programs (such as Medicare, Missouri Medicaid, and VA benefits), insurance (including health, long-term care, and workers’ compensation), and self-pay options. When you call our Intake Nurse, you can expect us to be better prepared than other home care companies to assist you and your aging parent with their home care needs.
Additionally, by accepting any form of funding, we can support your aging loved one even if their care needs change over time. Some home care companies only accept Medicare or private self-pay services. Medicare typically covers only short-term nursing and therapy, while private services primarily focus on caregiver support. At Cooperative Home Care, we can provide both types of care seamlessly as your loved one’s needs evolve.
Choosing a home care company that does not accept all forms of funding could require you to coordinate with multiple providers, which can increase costs, add stress, and reduce the overall effectiveness of care.
What Are Your Payment Options for Home Care?
Medicare
If you are over 65 or older, you qualify for Medicare. Many people incorrectly think that Medicare will pay for all of their health care needs when they are older, but this is not necessarily true. When it comes to home health care, Medicare will only pay for skilled-type services. These are services that can only be provided by a skilled, licensed clinician like a nurse or a therapist.
If you have been hospitalized, and still have the potential to improve as you are discharged home, your doctor may prescribe a home health care assessment. Many hospitals have their own home care company but you can choose any company as your home care provider. Within a day of returning home, a nurse or physical therapist will come to your home to complete an assessment of your needs. This information is submitted to your doctor and he/she will approve services appropriate for your needs. For example, if you need nursing care, a nurse may visit you two or three times per week. Your home health care nurse may also educate you or a family member about how you can begin to perform your own nursing care (as appropriate). Every Medicare approval period, or “episode”, lasts about 30-60 days, as long as you are working hard and making progress. You may even be approved for an additional days if needed. If you get better sooner, or no longer need this specialized assistance, your services will be discontinued. Aside from hospitalization, other common reasons one begins receiving Medicare home health care is if they have a new diagnosis, or if their condition has suddenly declined.
Other services available during your episode(s), depending on your health care needs, may be physical therapy visits to help you regain your strength and mobility, or a social worker to help you access community resources, or an occupational therapist to ensure you can perform all of your own self-care safely. You may even qualify for a few Home Health Aide visits. Your Home Health Aide can help you bathe until you can do so on your own or with help from a trained family member. None of your clinicians can help you with ongoing safety and supervision, or to do your laundry (for example) if you cannot go up and down steps when you return home; Medicare pays for skilled services only.
Medicare will pay 100% for the services described above if you qualify. If you need a walker to move around safely Medicare may only pay 80%, so you’ll have to pay the remaining 20% out-of-pocket or through a supplemental insurance if you have one.
Our, ‘Do I Qualify for Medicare Home Health Care?’ checklist is a helpful tool for understanding if Medicare home health care is an option for you:
Do I qualify for Medicare Home Health Care?
Medicare home health care solutions are for clients for whom it is a taxing effort to leave home, who have had a recent decline in condition, and need skilled nursing or therapies to get better. It is NOT long-term care. Our Medicare services include skilled nursing, physical, occupational and speech therapies, social worker services and Home Health Aides (for baths only).
What are the Warning Signs you or your loved one needs help?
Problems Taking Medication Correctly
Supervision needed
Falls
Decline in health
Hospitalization
Missing meals
Missing appointments
Incontinence
New diagnosis (such as CHF, COPD, or diabetes)
Won’t leave home
Poor hygiene
Concerns about safety
Planned hospitalization or surgery (knee or hip replacement, bypass, etc.)
To qualify for Medicare home health care, you:
Must be Medicare-eligible (65+, disabled or kidney disease)
Must need skilled nursing and/or therapy
Must have potential to improve as a result of care
Must be under a physician’s care
Must be homebound, which means:
Unable to leave home w/o assistance
Away from home only for short intervals
Any absence requires a taxing effort
Patients can attend religious services, go to healthcare appointments and grooming appointments
If you checked any Warning Sign(s), and all of the qualifiers, please call Cooperative Home Care to get started!
MO Medicaid In-Home and CDS
Unlike Medicare, you must qualify financially for Medicaid. Another way to remember this is that Medicare is a federal program designed primarily for seniors, while Medicaid is managed state by state and is designed for individuals with very low incomes and/or disabilities. First, one must qualify financially by earning approximately $1732 or less/month as an individual, or $3000 or less/month for a family. To receive in-home services through Medicaid, one must also qualify by needing assistance with some of their activities of daily living like bathing, dressing, going to the bathroom and/or walking. To enroll in Consumer Directed Services (“CDS”), you must also be able to train, direct, and employ your own caregiver-with help from us. There is an approval process that takes approximately 30 days from the time you apply for in-home services/CDS. Cooperative helps clients who are new to the in-home services/CDS program as well as clients who have received these services for many years. If you are receiving Medicaid in-home services/CDS and you also qualify for Medicare, then if you are hospitalized you may receive Medicare home health care to help you regain your strength and improve as much as possible before resuming your Medicaid in-home care/CDS to maintain your current independence level at home.
Private Services (Self Pay)
After examining every other funding option: Medicare, Medicaid, VA, Medical Insurance, Long-Term Care Insurance, Worker’s Compensation and Reduced Fee Programs, clients may pay out-of-pocket for some or all of their home care solutions.
Now, you’ve got the basics of home care funding. When you’re ready, call our Intake Nurse for information on how to pay for home care specifically tailored to your aging parent’s needs.
Veterans Affairs
The Department of Veterans Affairs pays for two main types of home care. The first is Fee-based services and the second is through the Aide and Attendance pension. If you are a veteran who was active duty status for at least one day during which our country was officially at war, you may qualify for this pension which reimburses you for part of your home care expenses.
Health Insurance
Your health insurance policy may pay for skilled services prescribed by your physician, similar to Medicare. If you have medical insurance and Medicare, your insurance must pay before Medicare may pay any remaining portion.
Long-term Care Insurance
One may elect to enroll as early as when he or she is in their 40s, paying a monthly premium. Policies vary greatly from the cost of monthly premiums, to the amount of paperwork required to access benefits, to approved services (including skilled care, assisted living, caregiver visits or a combination). One big challenge is to accurately choose the policy appropriate for your anticipated long term needs.
If you have long-term care insurance, we will help you understand and access your benefits.
Worker's Compensation Insurance
This insurance will pay for your medical needs as a result of a work-related accident or injury. Cooperative offers a specialized Worker’s Compensation Program.
See the Benefits of Jefferson County and Crystal City Home Care
Why Choose Cooperative Home Care?
Faithfully serving clients for over 39 years with trusted care
Any amount of care to fit your schedule and needs
Comprehensive services for any need from nursing to companionship
We provide care for all ages with personalized solutions
We help qualify you for funding to reduce out-of-pocket costs
Fast response time to meet your urgent care needs
Compatible caregivers matched to your loved one’s personality
Licensed and insured professionals you can trust completely
Free assessment and care plan to get started today
Get Started With Our Crystal City and Jefferson County Home Health Care
Transform Your Loved One’s Life With Our 3 Simple Steps
Schedule Your Free Assessment
Call (636) 637-0325 to set up a no-obligation in-home evaluation.
Create Your Custom Care Plan
We’ll design a plan tailored to your loved one’s needs.
Start Receiving Care
Our compassionate caregivers begin providing support right away.
Your Crystal City and Jefferson County Home Health Care Partner
Transform your loved one’s life with care that lets them live confidently and comfortably at home
Call us at (636) 637-0325 or fill out this simple form to schedule a call.
Our Crystal City and Jefferson County Office
Jefferson County Office
1006 N. Truman Blvd. #A
Crystal City, MO 63019
(636) 637-0325
Cooperative Home Care Service Locations
Cooperative Home Care proudly services:
Counties: Crystal City and Jefferson County, Franklin County, St. Louis County, St. Clair County, St. Charles County, Lincoln County, Warren County, Randolph County, Monroe County, Washington County, and Clinton County.
Cities: St. Louis, Crystal City, East Crystal City and Jefferson County, Clayton, Chesterfield, Town and Country, Brentwood, Florissant, Glendale, Kirkwood, Rock Hill, Creve Coeur, Fairview Heights, Belleville, Swansea, Granite City, Edwardsville, Glen, Carbon, O'Fallon, Maryville, Alorton, and Lebanon.
