Personal care payment and coverage options
Coverage is not guaranteed simply because an insurance company is listed below. Eligibility depends on the member's plan, medical or functional need, authorization requirements, provider type, network participation, and the specific benefit. E'Lou can help identify what should be verified before services begin.
Florida Medicaid Long-Term Care
Personal care is a covered service within Florida's Statewide Medicaid Managed Care Long-Term Care program when the member is eligible, the service is authorized, and the provider meets the health plan's network requirements.
Medicaid Managed Care Plans
Depending on eligibility, region, authorization, and network participation, plans may include Florida Community Care, Humana, Simply Healthcare, Sunshine Health, UnitedHealthcare, and other applicable Florida Medicaid plans.
Long-Term Care Insurance
Many long-term care insurance policies include benefits for assistance with activities of daily living. Coverage, elimination periods, daily limits, and approved provider requirements vary by policy.
Medicare Advantage & Commercial Health Plans
Some Medicare Advantage and commercial plans may include home-health-aide, in-home support, or supplemental home-care benefits. Benefits must be verified because coverage differs substantially by plan.
VA-Authorized Home Care
Eligible Veterans may qualify for VA-authorized Homemaker/Home Health Aide or other home- and community-based services that include help with personal care and activities of daily living.
TRICARE
TRICARE may cover home health aide services as part of an authorized home health benefit. Coverage requires prior authorization and generally must be provided through a participating home health agency.
Workers' Compensation / Injury Cases
Certain injury-related cases may authorize attendant care, personal assistance, or other in-home services when medically necessary and approved by the responsible payer.
Private Pay
Families may also arrange personal care directly using private funds when insurance does not cover the service or when additional hours are desired.