Does Medicare Cover Visiting Angels?

With help from personal care aides, seniors who might otherwise require residential care may be able to remain in their own homes. Agencies such as Visiting Angels match individuals with licensed, insured caregivers who can provide essential services, including assistance with daily activities, and palliative and end-of-life care. However, because Medicare doesn’t cover non-medical aid, the program typically won’t pay for the services of Visiting Angels and similar companies. Here’s what else you should know.

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What Is Visiting Angels?

Visiting Angels is a home care agency that specializes in providing customizable non-medical services for individuals who can live on their own with the proper assistance. This franchise-based company consists of a nationwide network of independently owned care providers who deliver services in some or all of the following categories:

• Alzheimer’s care
• Companion care
• Dementia care
• End-of-life care
• Fall prevention
• Palliative care
• Personal care
• Post-hospital care
• Respite care
• Social care

Seniors may receive services on a temporary or long-term basis, including 24-hour or live-in care. Visiting Angels also provides aid in assisted living residences and other community settings, as long as the facility permits care from outside providers.

Does Medicare Cover Visiting Angels?

Original Medicare covers care that’s deemed medically necessary by an approved plan physician. The program doesn’t typically pay for long-term care services and supports, such as those provided by Visiting Angels, because they're considered custodial rather than medical.

However, some Medicare Advantage (Medicare Part C) plans offer additional benefits, may may include cover certain in-home services provided by Visiting Angels, such as bathing, grooming and oral care. These MA policies, which are administered through Medicare-approved private insurers, differ by plan and carrier.

A licensed insurance agent can provide details about coverage, restrictions, out-of-pocket costs and other information for Medicare Advantage plans available where you live.

Is Visiting Angels Covered by Medicaid?

Medicaid provides health care benefits to low-income seniors. Because plans are administered by individual states, guidelines governing coverage and eligibility vary depending on where you live. However, in most areas, Medicaid covers at least some in-home care services, such as those provided by Visiting Angels. This coverage may be provided through one of two channels:

• Regular Medicaid: In some states, Medicaid covers in-home personal care assistance, which may include help with bathing, eating, dressing and other non-medical services.
  
  
• Medicaid waivers: Some states also offer Home and Community-Based Services waivers, which are designed to help seniors stay in their homes longer. These waivers typically pay for in-home services and supports such as companionship care and assistance with the activities of daily living. However, because HCBS waivers are not based on entitlement, approved applicants may be placed on a waiting list until the program has an opening.

Is Visiting Angels Covered by Private Insurance?

Some private insurance policies may provide full or partial coverage for in-home personal care services related to aging-related disabilities or a diagnosed illness. However, because coverage differs by insurer and plan, an insurance company representative is typically the best source to find out what Visiting Angels services your plan covers.

What Other Programs Provide Financial Assistance for Visiting Angels Services?

If your medical insurance doesn’t cover the cost of Visiting Angels, financial assistance to help defray out-of-pocket costs may be available through the following sources. 

• Long-term care insurance: Seniors who’ve invested in long-term care insurance may use it to pay for services that aren’t covered under Medicare or other health care insurance. Typically, the insured must be diagnosed with a qualifying condition, such as Alzheimer’s, before a plan pays out benefits.
  
  
• Life insurance: Some life insurance policies include living benefits, which let policyholders who've been diagnosed with chronic or terminal illnesses access funds to pay for care. Living benefits are included in some policies, or may be purchased as riders.
  
  
• Veterans' programs: Veterans and their spouses may be entitled to assistance from the U.S. Department of Veterans Affairs through programs such as Veteran-Directed Care. This program provides qualified veterans with a budget to pay for services that can help them manage their daily needs.
  
  
• State assistance programs: Many states offer programs designed to help elder citizens remain in their homes rather than transitioning to residential care. These programs, which typically provide financial assistance for in-home services, can often be found by contacting your local Area Agency on Aging.

How Much Does Visiting Angels Cost?

Visiting Angels customizes plans to suit the care and budgetary requirements of each individual, and costs vary depending on the region and the type and frequency of the services provided. Most Visiting Angels franchises offer no-cost in-home consultations to assess the individual's care needs. Afterwards, a care coordinator constructs a personalized plan, and an hourly rate may be quoted. 

Because Visiting Angels consists of franchises across the country, each agency may accept different forms of payment. A local Visiting Angels office can provide additional information about costs and coverage options for services.