Cost and Eligibility

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Our care programs offer unique services tailored for specific situations. Some types of care are paid for by Medicare and Medicaid. Others may be covered by long-term care insurance. Some may need to be paid privately.

If you have questions, ask us. We can help you find out which program is the best for your situation and what is and isn’t on your plan.

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Home Health Eligibility and Costs

Home health care involves home visits by medically trained specialists to patients who are unable to leave the house and come to an office or clinic. The goal is to restore the patient’s ability to live as healthily and independently as possible. Or at least maintain the patient’s current health and abilities and not lose ground.

Eligibility:

  • Patient must need skilled care by a trained professional. Typically, this means a nurse, a physical therapist, a speech therapist, a dietician, a social worker, etc.
  • Patient’s need for care is medically necessary and part of generally accepted practice for the condition.
  • The care needed is part time and intermittent. (This is not for having someone live in the home. It is for periodic visits now and then.)
  • Patient must be “homebound,” meaning due to illness or disability, he or she cannot go out for much more than medical care, and worship.
  • Patient must have an order from a physician requesting home health services.

Cost:

Depending on your insurance, and as long as you meet the eligibility requirements, most home health services are covered according to your plan. This means you are still responsible for any deductible or co-payments.

Medicare, for example, covers 80% of home health services. If you have a Medi-gap (supplemental) policy, usually they will pick up the 20% of what Medicare doesn’t cover. (Be sure to tell the doctor you have supplemental insurance so he or she can file any necessary paperwork.)

There may be services, equipment or supplies that are not covered by your insurance. If that’s the case, we will let you know so you can make choices.

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Palliative Care Eligibility and Costs

Depending on your loved one’s condition, palliative care may or may not be covered by insurance. There are programs that can assist with the cost to the point that your loved one may be able to receive services at no charge. Give us a call at 916-281-3900 to learn more.

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Hospice Eligibility and Costs

If the person you care for has an incurable condition, hospice care is available at no charge. Patients and families can call and request the support of hospice. Ultimately the patient’s doctor must certify that the patient meets eligibility requirements.

Eligibility:

  • Patient must have an incurable illness.
  • A physician must certify that he or she would not be surprised if the patient were to pass away within the next 6 months.
  • Patient must be willing to forego curative treatments in favor of treatments that promote comfort and quality of life.

Cost:

  • Medicare, Medicaid and most insurances will cover 100% of hospice services.
  • No one will be turned away due to an inability to pay.
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