Medicare

Medicare Parts A and B do not cover ongoing assistance with Activities of Daily Living (ADL), categorized as "custodial care" within Medicare plan exclusions. However, there's a provision for home health aide services covering skilled care provided by healthcare professionals, including nursing, physical therapy, and occupational therapy. These services are typically limited and respond to acute needs.

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Medicare Advantage (Part C) may include coverage for some in-home support services. Insurance companies offering Medicare Advantage plans can customize coverage beyond the basic home health aide benefit. Additional requirements may apply.

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Medicaid​

State-specific initiatives and programs aim to support qualifying seniors under Medicaid to remain comfortably at home rather than in nursing facilities. These programs offer coverage for in-home care expenses, provided that the cost is lower than that of a nursing home.

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If you have any questions or need assistance with determining payment options, please contact us using the EXPLORE ULife Health online form.