Are you wondering if your insurance will cover the cost of home care for an aging parent or loved one?

You’re not alone. Many families are searching for guidance on how to pay for in-home care services -especially as the need for home care continues to grow. At 7 Day Home Care, we specialize in providing compassionate, reliable care to seniors across New York City, Manhattan, Queens, Brooklyn, Long Island, and surrounding areas. This guide will explain how different types of insurance—including Medicare, Medicare Advantage, Medicaid, long-term care insurance, private health insurance, workers compensation insurance, disability insurance, accident insurance, and more—can help cover the cost of home care.

What is the Difference Between Home Care and Home and Home Health Care?

Home care (non-medical) and home health care (medical) are two distinct types of in-home support services designed to help individuals remain safely and comfortably in their own homes, but they serve different needs. Non-medical home care focuses on assisting with activities of daily living (ADLs) such as bathing, dressing, grooming, meal preparation, light housekeeping, medication reminders, and companionship. These services are typically provided by home health aides (HHAs) or personal care aides (PCAs) and are ideal for seniors or individuals with chronic conditions who need support with daily routines but do not require skilled medical intervention. In contrast, home health care involves medical services delivered by licensed professionals such as registered nurses (RNs), physical therapists, occupational therapists, and speech-language pathologists. These services may include wound care, IV therapy, injections, and rehabilitation following surgery or hospitalization.

Does Insurance Cover Home Care? (Short Answer)

Yes—but it depends on the type of insurance and the level of care required. Not all insurance covers non-medical home care (such as meal preparation, companionship, bathing, dressing, etc.), but many forms of insurance do help cover skilled medical services at home or long-term care for qualifying individuals.

Types of Insurance That May Cover Home Care

Does Original Medicare Cover Home Care?

Under Medicare Part A and Part B, home care services are covered only if they are medically necessary and meet specific eligibility criteria. Medicare covers intermittent skilled nursing care, such as wound care, injections, or monitoring of serious health conditions, provided by a registered nurse or licensed practical nurse. It also covers physical therapy, occupational therapy, and speech-language pathology services if these therapies are necessary to treat the patient’s illness or injury and are expected to result in a meaningful improvement in the patient’s condition. Additionally, extremely limited part-time or intermittent home health aide services may be covered, but only if the patient is also receiving skilled nursing care or therapy services at the same time. Home health aide services must be related to the patient’s medical needs—such as assistance with bathing or personal care—and cannot be the sole service provided. To qualify, the patient must be homebound (leaving home requires considerable effort), and the services must be ordered by a physician and delivered through a Medicare-certified home health agency. Medicare does not cover 24-hour home care, meal delivery, housekeeping, or personal care services not tied to skilled care.

Medicare Advantage (Part C) and Home Care

Medicare Advantage (Part C) plans are offered by private insurance companies approved by Medicare and are required to provide the same basic coverage as Original Medicare (Parts A and B)—including coverage for home health services such as intermittent skilled nursing care, physical therapy, occupational therapy, speech-language pathology, and part-time home health aide services when tied to medical necessity. However, unlike Original Medicare, many Medicare Advantage plans also offer additional supplemental benefits related to home care that can vary by provider and plan. These may include personal care services (such as help with bathing, dressing, and toileting), homemaker services (like light housekeeping, laundry, and meal preparation), transportation to medical appointments, and in-home support for managing chronic conditions such as diabetes, heart failure, or dementia. Some plans may even offer flexible, non-medical supplemental benefits designed to improve quality of life for chronically ill members, as allowed under recent Centers for Medicare & Medicaid Services (CMS) policy updates. Because benefits and eligibility criteria can vary significantly between plans, it’s essential to review your specific policy or consult with a care coordinator at 7 Day Home Care, who can help verify coverage and explain what services may be available through your Medicare Advantage provider.

Medicaid and Home Care Services

Yes, Medicaid does cover home care services, and it is one of the largest payers of long-term in-home care in the United States—particularly in New York State. Medicaid provides essential support for low-income individuals who require assistance with daily living activities or medical care at home. Covered services often include personal care aides (PCA) who help with bathing, dressing, and toileting; certified home health aides (HHA) who may provide both personal and limited health-related care; private duty nursing for individuals with complex medical needs; and access to medical equipment and supplies necessary for in-home treatment. In New York, Medicaid also offers several Managed Long-Term Care (MLTC) plans that provide comprehensive coverage for seniors and individuals with chronic illnesses or disabilities who require extended home care. These plans may include case management, home-delivered meals, and transportation services in addition to personal care. To qualify for Medicaid home care, individuals must meet both financial eligibility criteria (based on income and assets) and clinical requirements that demonstrate a need for ongoing assistance.

Private Health Insurance and Home Care

Private health insurance generally provides very limited coverage for home care services and typically only covers short-term, medically necessary care—often following a hospitalization, surgery, or acute illness. These plans may pay for services such as post-operative nursing care, wound care, physical therapy, and occupational therapy. but only when those services are prescribed by a physician and deemed essential for recovery. However, private health insurance does not usually cover non-medical or long-term home care needs, including personal care, companion care, meal preparation, bathing assistance, or 24-hour supervision—even if those services are critical to a patient’s quality of life or safety at home. In addition, coverage terms can vary widely depending on the insurer, plan type, and state regulations. Some employer-sponsored or marketplace plans may offer slightly broader benefits, while others are more restrictive. Because of these inconsistencies, it is essential for families to review their policy documents carefully or consult with experts at 7 Day Home Care, who can help interpret private insurance coverage and identify any available short-term benefits that may apply to a loved one’s situation.

Private Long-Term Care Insurance

Yes, private long-term care insurance is one of the most effective and flexible options for covering the cost of home care services, particularly for aging adults or individuals with chronic illnesses or disabilities. Unlike traditional health insurance or Medicare, long-term care insurance is specifically designed to cover extended, non-medical care that supports individuals with activities of daily living (ADLs) such as bathing, dressing, eating, toileting, transferring, and continence. Most long-term care policies cover the cost of Home Health Aides (HHAs) or Personal Care Aides (PCAs) who provide assistance in the home, allowing individuals to age in place rather than moving into assisted living or nursing facilities. Some policies also cover services like light housekeeping, meal preparation, companionship, respite care for family caregivers, and in some cases, adult day programs. Benefits typically begin once a person is unable to perform a certain number of ADLs independently—usually two or more—and after satisfying an elimination period, which is like a deductible measured in days. At 7 Day Home Care, we work with families across New York City, Queens, Brooklyn, Long Island, and beyond to help them activate long-term care policies, coordinate benefit approvals, and ensure ongoing documentation so they can fully utilize the coverage they’ve invested in.

7 Day Home Care is an approved provider for all major long-term care insurance plans, including:

• Brighthouse
• Genworth
• John Hancock
• MetLife
• New York Life
• Bankers Life
• CNA
• Mutual of Omaha
• UNUM
• Northwestern Mutual
• Nationwide
• MassMutual
• Lincoln Financial Group
• Thrivent
• National Guardian Life
• TransAmerica

Tip:

Long-term care policies vary—some pay a daily amount, others reimburse actual costs. We help families with their claims filing, overage verifications, and ongoing claims documentation support.

Catastrophe and Catastrophic Health Insurance

Catastrophic health insurance is a high-deductible, low-premium insurance option designed to provide financial protection in the event of serious, unexpected medical events—but it is generally not intended for ongoing elder care needs. These plans typically only cover essential health benefits after the deductible is met and are best suited for younger, healthy individuals or as a safety net in case of major emergencies like hospitalization or severe illness. However, in some cases, catastrophic insurance policies may offer limited coverage for short-term, medically necessary home care services, such as skilled nursing following a hospital discharge. A few policies may also reimburse for non-medical home care services—like help with bathing or dressing—but only for brief durations and in very specific post-acute situations. Unlike long-term care insurance, catastrophic plans are not structured to provide extended daily support, and they do not cover services like companion care, 24-hour supervision, or long-term personal assistance at home. Because coverage under these plans varies significantly by insurer and often comes with high out-of-pocket costs before benefits begin, it is crucial to review your policy closely or consult with a provider like 7 Day Home Care, who can help clarify what services, if any, are eligible for reimbursement under your catastrophic plan.

Disability Insurance

Disability insurance is designed to provide income replacement when an individual is unable to work due to a qualifying illness or injury, but it does not directly cover the cost of home care services. Instead of reimbursing or paying for specific care providers or services, disability insurance offers a monthly benefit—typically a percentage of the person’s pre-disability income—that can be used at the recipient’s discretion. This income can help pay out-of-pocket for non-medical home care, such as assistance with activities of daily living (ADLs), or even skilled in-home nursing services, depending on the individual’s needs and preferences. Disability insurance can be especially helpful for individuals under the age of 65 who experience a sudden or chronic disability and require assistance at home but do not yet qualify for Medicare or long-term care coverage. Both employer-sponsored disability insurance and private individual disability policies may provide this type of benefit. While the insurance does not directly coordinate care or vet providers, families can work with agencies like 7 Day Home Care to create a care plan that aligns with the available monthly benefit, helping to stretch resources and ensure consistent support for the disabled individual.

Accident Insurance (Including Auto Accidents)

Accident insurance, including policies tied to auto accidents, may provide limited coverage for home care services, depending on the nature and severity of the injury and the terms of the policy. These types of insurance are generally intended to help cover unexpected medical expenses following an accident—such as a car crash, fall, or other traumatic event—and may include benefits for in-home rehabilitation, temporary skilled nursing services, or the use of medical devices and equipment during recovery. Some accident insurance plans offer a lump-sum payout that can be used at the policyholder’s discretion to help cover out-of-pocket home care costs. In cases where the accident involves another driver, their auto insurance may include Personal Injury Protection (PIP), which can help pay for necessary in-home care, such as nursing visits, personal assistance, or physical therapy, particularly in no-fault insurance states like New York. However, accident insurance typically does not cover long-term personal care, companion care, or non-medical home services unrelated to injury recovery. Because coverage is often situation-specific, families should consult both their accident insurance policy and a trusted home care provider like 7 Day Home Care to determine what services may be eligible for reimbursement and how to initiate claims following an injury.

Veterans Benefits and Home Care

The Veterans Aid and Attendance (A&A) Program is a special benefit offered by the U.S. Department of Veterans Affairs (VA) that provides monthly financial assistance to eligible wartime veterans and their surviving spouses who require help with daily living activities. This tax-free benefit is designed to help cover the cost of in-home care, assisted living, or nursing home services for those who need assistance with tasks such as bathing, dressing, eating, toileting, or mobility. To qualify, the veteran must have served at least 90 days of active duty, with at least one day during a wartime period, and must meet clinical and financial criteria, including a demonstrated need for aid and attendance and limited net worth (excluding a primary residence and vehicle). Unlike standard VA pensions, Aid and Attendance is an enhanced pension benefit that provides additional funds on top of the base pension. Many families are unaware of this program, even though it can significantly reduce out-of-pocket expenses for long-term care. At 7 Day Home Care, we help veterans and their families in New York City, Long Island, Queens, and surrounding areas understand eligibility requirements, gather the necessary documentation, and apply for Aid and Attendance to access high-quality in-home support.

When Insurance Doesn’t Cover Home Care: What Are Your Options?

If your insurance doesn’t fully cover in-home care, there are still several options available to help families afford the services their loved ones need. Many families choose to pay for private home care services either hourly or through live-in care arrangements, depending on the level of support required. These services can be funded through out-of-pocket payments or shared among family members to help manage the cost. For individuals who already have a basic long-term care policy, adding a supplemental long-term care insurance plan may help bridge coverage gaps. In some cases, state programs or nonprofit organizations offer grants or financial assistance for seniors, particularly those with low incomes or specific medical conditions. Homeowners may also consider reverse mortgages or home equity loans to unlock the value of their home and use those funds to pay for in-home care. Additionally, individuals who do not yet qualify for Medicaid may benefit from Medicaid spend-down planning, a legal strategy that involves reducing countable income or assets to meet Medicaid eligibility requirements. At 7 Day Home Care, we understand that navigating care costs can be overwhelming, which is why we offer flexible, customized care plans designed to meet both your loved one’s medical and personal needs—even when insurance coverage is limited or unavailable.

How to Check If Your Insurance Covers Home Care

Step 1: Contact Your Insurance Provider
Request a detailed explanation of home care benefits.

Step 2: Call 7 Day Home Care at 516-408-0034
We’ll help review your plan and match it with services we provide.

Step 3: Get a Free In-Home Assessment
We’ll create a care plan and explain what services are covered vs. not.

Why Choose 7 Day Home Care?

Choosing 7 Day Home Care means partnering with a trusted, experienced, and compassionate home care agency that is fully equipped to support your family’s needs. We are an approved provider for many major insurance programs, including long-term care insurance, Medicaid-managed care plans, and workers' compensation insurance. Our team is highly experienced in handling the complexities of long-term care insurance claims, from verifying policy coverage to submitting documentation and securing ongoing authorizations, making the process easier and less stressful for families. Licensed by the New York State Department of Health, 7 Day Home Care upholds the highest standards of quality and compliance in all the services we provide. We proudly serve clients across Manhattan, Queens, Brooklyn, and Long Island, offering personalized care solutions that are both flexible and reliable. Our compassionate and certified home health aides (HHAs) are trained to assist with activities of daily living, medication reminders, mobility support, and more—helping clients maintain their independence and dignity at home. For families in need of around-the-clock assistance, we also provide 24/7 live-in care options, ensuring consistent and dependable support no matter the time of day or night.

Still Unsure What Insurance Covers Home Care Services?

Call us today at 516-408-0034 or visit here to schedule your free consultation. We’ll help you get the care your loved one deserves - with or without insurance. 7 Day Home Care provides private pay in-home care services and is an approved provider under many insurance policies, including your long term care insurance policy - throughout NYC, Manhattan,  Queens,  Brooklyn, and Long Island, New York. To learn more about home health aide care services, please call 516-408-0034.

Brian Callahan

7 Day Home Care