Different Kinds of Home Care Agencies

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Long term care can include different kinds of home care agencies for you or your loved one. The definition of services is mirrored in the different types of home care agencies.

  • Medicare-certified home health agencies( HHAs): These are agencies approved by the Center for Medicare & Medicaid Services (CMS) and licensed by the state to provide skilled services, primarily nurse visits, but also physical therapy or social-work visits, among others.

    Medicare will only pay for services provided through an HHA. If there is a skilled need, HHAs may also provide aide services through their own aides or through another agency, usually a licensed agency, with which they have a contract. Medicare does not pay for aide services at home unless there is a skilled need.

    You can compare HHAs in your area at www.medicare.gov/homehealthcompare/search.aspx. This site can give you some general information, but it can't tell you about important aspects of care such as how reliable and friendly an agency's workers are.

  • Licensed home care agency: Most but not all states license home care agencies to provide nursing services and aides who do personal care. Some are contracted through Medicaid to provide long-term personal care.

    The Genworth 2013 Cost of Care Survey reported a national median hourly rate through licensed agencies of homemaker or companion services to be $18 and the personal care services to be $19. Obviously, rates vary by geographic area.

  • Non-medical or companion agency: These rapidly growing agencies are not usually licensed by state health departments or regulated by the federal government, and their services are not covered under health insurance because they are deemed nonmedical.

    Companion services include reading and conversation, assisting with clothing selection, organizing the mail, and picking up prescriptions from the pharmacy. Workers have varying levels of experience and training. Frequently companion agencies are locally run businesses that are franchises of large, brand-name companies. The rates for these services can range from $15 to $25 an hour.

    Companion agencies may list medication management among the nonmedical tasks within their range of expertise.

    However, if you or your family member are taking many medications of different sorts or they have to be taken in specific doses or at specific times, a companion may not have the necessary training to help with this task if it involves anything more than reminding the person to take the pills that have already been set up in a pill box.

  • Employment or registry agencies: These agencies provide names of nurses and aides available to provide home care. You contact and pay them directly. Your state may also maintain a registry through the Department of Health. PHI National has a map showing which states have this service. Some states limit access to publicly funded (Medicaid) clients; others are more flexible.

Medicare only pays for home healthcare services provided by a certified HHA, and both Medicare Advantage plans and private insurance may require you to use only an HHA within their network. If you pay privately and want to use an agency, you can decide which one to use.

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