Neither Medicare nor Medicare supplements or other private health insurance plans cover non-medical home care. Medicare will cover short-term, intermittent care services in the home through a licensed agency. For example, Medicare may pay for a physical therapist to come to your home 1-2 times per week after a change in your condition to help you regain mobility so that you can stand to make dinner, take a shower, etc. But Medicare will not pay for someone to prepare meals, give you medication, take you to the doctor, do laundry, or do light housekeeping when you cannot do these things yourself.
In reality, home care is one of the most affordable care options, partly because of the flexibility of the number of hours or the rate of pay. When choosing care at home, as opposed to a nursing home or assisted living, you are able to hire a caregiver for any number of hours to meet your needs and your budget.
Reputable home care companies will try to match caregivers with seniors of similar interests, but more often than not, the caregiver sent to you is the caregiver who is available. You should make sure that a company’s caregivers are screened, skilled, and bonded, and that a background and reference check has been done. The company should also offer flexibility in setting up a schedule – and be sure they’ll provide back-up and replacement caregivers. With a unique service like The Home Care Company, you get all of that PLUS you view a caregiver’s professional video and online resume so the choice of which pre-screened and highly recommended caregiver to hire on your own is always yours.
Nobody works around the clock, day in and day out without a break – nor could they function properly if they did. Each state has strict laws to protect household workers, and remember that any live-in caregiver you hire on your own or through an agency must be allowed at least 5-8 hours of uninterrupted sleep in most states or must be paid (often time-and-a-half) on days that does not happen. With recent changes to the laws regarding overtime pay, you must check to be sure the caregiver is properly paid.
All licensed home-care businesses are different – some fully abide by the rules and regulations set out by their license while others simply pay their state or local business license fee and practice as they please. Be sure you know who you are trusting with your care or the care of a loved one.
The IRS has ruled repeatedly that caregivers and other household employees who earn more than $2,200 a year (2020) are legally determined to be household employees who must be processed with a Form W-2 and not a 1099 form. (To qualify as a 1099 independent contractor, the worker must show they are truly independent based on such factors as whether they have a choice of what days and times to work, they bring their own supplies to work, and even a choice of where the work is done.) As the employer of a caregiver in the United States, you have a responsibility to follow all applicable federal and state labor laws and regulations including paying FICA taxes, accurately tracking hours worked, paying overtime, and securing worker’s compensation coverage for injuries on the job. Failure to do so results in back payment and civil penalties from both the federal government and state authorities.