Home Care and Community Care Benefits
Services provided by home health agencies are referred to as Home Care and Community Care Benefits. This can include a Registered Nurse, Licensed Practical Nurse, Physical Therapist, Occupational Therapist, Nurse’s Aide, non-medical homemaker services, at home hospice care and adult day care. Some insurance companies will recognize a family member or friend with in this benefit plan with prior authorization to be paid for their time and expense in being a caregiver. Usually this would not apply to someone that is currently living within the same home as the insured, including their spouse.
Facility Care
Care received within a nursing home, hospice facility or assisted living facility is referred to as Facility Care. These benefits are used to cover the cost of room and board, nursing care, personal care and hospice care within the facility. Most plans will offer a bed reservation as well allowing the insured to leave for a short period of time while the insurance plan pays for the amount of time for the patient to be able to return. Bed reservation benefits typically last about 30 days per policy year.
Respite Care
Respite care is offered to those that have family members or friends caring for them. This benefit allows for the caregiver to have an opportunity to take a break from their responsibilities. The insurance company will provide care for that amount of time. Care can be received in a nursing home, adult day care, in home or in hospice facility. Most insurers will pay on average the maximum daily benefit for up to 21 days per year and the elimination period will not need to be met.
Alternate Plan of Care
The alternate plan of care is all services not clearly defined within an insurance plan. These plans will need to be approved by the insurer and is included in order to improve quality of life for the insured.
