Will Medicare Pay for 24-Hour Home Care?
Will Medicare pay for 24-hour home care? In most cases, no. Original Medicare does not pay for around-the-clock home care, or for personal (custodial) care when that is the only care someone needs. Families in Pasadena, CA still have real options.
This page shows what Right at Home Pasadena accepts, how we help with insurance claims, and what to check with each program before you plan around it. Coverage always depends on your own policy or program, so nothing here is a promise of payment.
How to pay for 24-hour and live-in care at a glance
Here is where each way of paying stands with Right at Home Pasadena:
| Way to pay | Used with us? | What to check |
|---|---|---|
| Private pay (credit card, ACH) | Yes, the standard way | A quote follows the free assessment |
| Long-term care (LTC) insurance | Yes: you pay, then claim reimbursement; we help with the claim | Your policy's terms |
| VA benefits | Yes, through TriWest, within what the VA approves | Your VA care team |
| Original Medicare | No | Does not pay for around-the-clock home care |
| Medicare Advantage | No | Your plan's own supplemental benefits |
| Medi-Cal | No | Ask the program what it covers |
Not sure which row fits your family? The free in-home assessment is the first step, and we can talk it through with you.
24 hour care insurance: long-term care policies and live-in caregiver insurance coverage
If your parent has a long-term care (LTC) policy, it may help with the cost of 24-hour care or a live-in caregiver. That depends on the policy. With us, the family pays first and then claims reimbursement from the insurer. We help you with the claim.
Before you count on it, ask your insurer:
- Is there a waiting period, and what eligibility rules apply?
- Which tasks are covered, and what are the benefit limits?
- Which records are required, and who submits them?
- Is it reimbursement only, or can the insurer pay the agency directly?
Also ask how the policy treats live-in care compared with shift-based care. A live-in caregiver stays in the home and helps at set times; it is not one person caring nonstop. See live-in care vs 24-hour care for the difference. We cannot promise approval of any claim.
Can VA benefits pay for 24/7 home care?
Right at Home Pasadena is an approved and contracted VA home care provider through TriWest. Care under VA benefits is available within the range the VA approves.
A few things to know:
- The VA medical team at your local VA medical center decides how many visits a veteran can receive.
- The service has to be started by the veteran or by their VA medical professional.
- Coverage depends on eligibility, clinical needs, local availability and authorization. Do not assume unlimited or 24-hour coverage.
A good first step is to contact your VA care team or social worker and ask about an assessment and authorized home care services.
24 hour home care Medicare and Medicaid: what usually isn't covered
- Original MedicareDoes not pay for around-the-clock home care, or for personal care when that is the only care needed. That applies to a live-in caregiver as well. Skilled home-health services that qualify are a different benefit.
- Medicare AdvantagePlans may offer supplemental benefits, so check the exact plan. Right at Home Pasadena cannot be paid through Medicare, including Medicare Advantage.
- Medi-CalCannot be used to pay for our care either. If you are looking into Medicaid-type programs for 24-hour home care, ask the program directly what it covers and which providers it works with.
These limits are why many families combine an LTC policy, VA benefits where eligible, or private pay.
Private pay: how billing works
Private pay is the basic way families pay here, by major credit card or ACH bank transfer.
- We do not publish hourly rates. After a consultation, we give you a quote based on the care and hours you need.
- Care is generally billed by the hour, after the service, usually weekly.
- If a couple receives care together from one caregiver, a discounted rate applies.
See cost and what's included for more on how a quote is built. When you are ready, start with a free consultation. Questions about payment terms are welcome at that first call.
Frequently Asked Questions
Does Medicaid pay for 24 hour home care?+
Not through us. Right at Home Pasadena cannot be paid through Medi-Cal. If you are exploring Medicaid-type programs, ask the program what it covers and which providers it uses. We can talk through other ways to pay.
Does Medicare pay for live-in caregivers?+
Original Medicare does not pay for around-the-clock home care or for personal care when that is the only care needed. We cannot be paid through Medicare, including Medicare Advantage. Check your plan if you have one.
Is a live-in caregiver covered by insurance?+
It depends on the policy. With a long-term care policy, you pay first and claim reimbursement, and we help with the claim. Ask your insurer about waiting periods, covered tasks and benefit limits. Approval is not guaranteed.
Can VA benefits pay for 24/7 home care in Pasadena?+
VA benefits can be used with us through TriWest, within what the VA approves. The VA medical team sets the number of visits, so do not expect unlimited or 24-hour coverage. Start by asking your VA care team.
Insurance
Plans we accept
- ✓VA benefits (TriWest)
- ✓Long-term care insurance
Questions about 24 Hour Care?
Call (626) 678-8826 or book a free in-home assessment to talk through how your family would pay.