Paying for Care
“What will this cost?” is usually the first question, and the honest answer is that it depends on which service you need, how much of it, and how it is funded. This page explains the routes that exist so you can work out which one applies to you. When you are ready to talk about your own situation, call us on +1 227 277 5967 and we will go through it with you.
The main ways care is paid for
Most people fund care through one of the following. They are not mutually exclusive — some families use more than one.
Medicaid waiver funding
Developmental disability supports are usually funded through a Medicaid Home and Community-Based Services waiver, administered by your state’s Developmental Disabilities Administration. If the person is found eligible, the waiver funds the services in their approved plan, and the provider bills the programme rather than the family. Your Coordinator of Community Services is the person who helps you understand what your plan authorises.
Private pay
Care arranged directly with an agency, paid for by the person or their family. This is the usual route for private duty and companion-style care for older adults. It is normally charged by the hour, with the rate depending on the level of skill the care requires — nursing costs more than personal support.
Long-term care insurance
If the person holds a long-term care policy, it may cover some or all of the cost of home care. Policies vary a great deal in what they cover, how many hours they allow, how long you must wait before benefits start, and which kinds of provider they will reimburse. Read the policy, or ask the insurer directly, before assuming a service is covered.
Other public programmes
Depending on circumstances, other public funding may apply — for example veterans’ benefits, or state programmes outside the developmental disability system. If you are not sure what the person qualifies for, a Coordinator of Community Services, a hospital social worker or your local agency on ageing can help you find out.
What changes the cost
Whichever route funds the care, the same handful of factors drive what it costs.
- The kind of support. Nursing delivered by a licensed nurse costs more per hour than personal support or companionship.
- How many hours. A few hours a week is a very different arrangement from overnight or around-the-clock cover.
- When. Nights, weekends and holidays are usually charged differently from weekday hours.
- The setting. Support in a person’s own home, in a residential setting, and in a day programme are funded and priced differently.
- How complex the needs are. Care that requires specific clinical skills, or two people rather than one, costs more to staff safely.
Questions worth asking about money
Ask these of us and of any other provider you are considering. You should be able to get a straight answer to every one of them before you commit to anything.
- What exactly is included in the rate, and what is billed separately?
- How are nights, weekends and holidays charged?
- Is there a minimum number of hours per visit or per week?
- What happens to the bill if a visit is cancelled, by us or by you?
- How and how often will I be invoiced, and what are the payment terms?
- If the care is waiver-funded, what does my plan authorise, and what would I have to pay for myself?
- How much notice will I get before a rate changes?
- Will you put all of this in writing before services begin?
Talking to us about your situation
There is no charge for a conversation, and no obligation. Tell us what support you are looking for and how you expect it to be funded, and we will tell you plainly whether it is something we can do, which funding route is likely to apply, and what you would need to have in place first. If we are not the right fit, we will say so and point you elsewhere where we can.