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There are a number of forms of private insurance that pay for home health care needs.
Employer Sponsored & Personal Health Insurance: In New York State, both employee sponsored and individually purchased health insurance provides home health aide coverage for limited periods. Some employers provide comprehensive retiree medical coverage, which supplements the gaps in Medicare and may provide some extra home care coverage, as well as drug coverage. Such coverage is often much more complete that any Medigap policy that can be purchased individually.
Long-Term Care (LTC) and related forms of insurance, whether provided by an employer, or purchased individually, provides specific dollar payments for the insured who requires assistance with the activities of daily living. Policies vary with regard to how many ADL's must require assistance before benefits are triggered (generally 2-3). Benefit amounts vary as well. Some policies provide benefits only when one is confined to a nursing home and others also provide benefits for home health care. Some policies only pay for expenses actually incurred by the insured, while others simply pay a daily benefit to the insured once the ADL requirement has been met, whether or not the insured actually pays for such benefits.
Premiums for LTC insurance vary with the age at which it is purchased. (As with life insurance, the older the person is, the more expensive the coverage.) LTC insurance is not available to those who already require assistance with ADL's. Such insurance can be a valuable means for protecting your assets when one needs long term home or institutional care. In New York State, there is a special kind of LTC insurance program called the "Partnership Program." It provides that anyone who owns a LTC policy which meets certain requirements can qualify for Medicaid, regardless of their assets, as long as the policy's benefits are exhausted before Medicaid benefits are applied for. Older adults in New York who wish to protect their assets, yet preserve the option to qualify for Medicaid, may find the Partnership program to be invaluable.
Insurers Accepted by the Visiting Nurse Service of New York:
Managed Care/Commercial
AETNA/US Health Care
AmeriChoice
Empire Health Care (formerly Empire Blue Cross/Blue Shield)
Fidelis (formerly Better Health Plan)
Group Health Incorporated (GHI)
Health First
HealthPlus
HIP of Greater New York
Independence Care Systems
Metro Plus
Multiplan Managed Care, Inc.
Neighborhood Health Providers
Physician's Health Services
United Health Care
Other Managed Care and Indemnity Insurance accepted on a case by case basis.
Union/Local Insurance Plans
1199 Benefit Fund
Local 3
Local 32BJ
Local 389
Local 30
Local 91
Mail Handler's Benefit
National Association of Letter Carriers
Other Union/Local insurance plans accepted on a case by case basis.
No Fault
Worker's Compensation
Private Pay or Out of Pocket
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