Home Healthcare Overview

Another determining factor of what home health care services are available to you is by the coverage guidelines of your particular insurance health plan. There are numerous health plans and every program has unique coverage guidelines of what services they can offer.

But for brief description, the insurance coverage can generally be grouped into the categories below.

Public Health Insurance Programs
Public Insurance plan are government programs administered by government agencies. They can be federal, state or local programs. The funding from these plans generally comes from compulsory taxation from the citizens; or the general public.

The Center for Medicare and Medicaid services (CMS) is the Federal agency that manages the respective programs. Medicare is public health coverage that provides access to health services for citizens that are over the age of 65.

Medicaid is public health coverage that provides access to health services for individuals and families with low income and assets, as well eligible persons with a disability. Medicaid is financed by the federal government in partnership with each state. Note: Medi-Cal is California's version of the Medicaid program.

The Department of Veteran Affairs provides health coverage for eligible veterans and every state operates a State Child Health Insurance Program (SCHIP) for children.

Private and Group Health Insurance Plans
Private and Group health insurance plans are policies paid for by an individual or their employer. These insurance companies allow anyone to join their network of services for a nominal fee.

As you can imagine, there are many different types of health insurance plans and providers. However, the insurance companies usually make arrangements to provide intermittent and long-term care included under specific tiers that indentify who receives unlimited access, and who must pay for extra services.

The numerous [Provider Networks] and the coverage guidelines of the various plans can be very detailed and complex. In most case, the insurer will have resources online available to you so you can have a better understanding the benefits of your policy.

Private Pay
Private pay refers to any service arrangements that you contract directly with the home care provider; without the involvement of outside insurance company or other administrators. Typical payment sources are self payments, a contractual agreement from a lawsuit settlement, an inheritance, or a living trust or will.

For obvious reasons, the services available to private pay have virtually unlimited by range of services, length and coverage.



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