One of the things that drives me nuts about home care is the name . . . Home care!

The reason being is that there are four different types of home care services and people often get confused about which service people are referring too.   So I thought it would be worthwhile to break down what those different types of home care services are and how they differentiate from one another.


1) VNA Certified Home Care Services

VNA stands for Visiting Nurses Association and what this means is that these specific home care companies are certified to be in reimbursed for their services by Medicare or Medicaid.

But there is a caveat to this type of service.  Most seniors use VNA home care right after being discharged from the hospital or a rehab facility. Usually, a fall injury or surgery has caused them to need these services once they go home.

Once VNA home care services are being utilized in someone’s home, they are generally there for 3 to 6 hours a week.  They provide one or two specific tests at a time they then leave within an hour or two of arriving.  Think of VNA services as a prescribed medicine, you take a pill at this time and then again after dinner.

The aides come in at this time and provide a sponge bath and leave.  The aides don’t usually hang around for hours an provide multiple services.

So while there’s no out-of-pocket cost for the services as the reimbursed by Medicaid and Medicare you also don’t get a whole lot of time with a home health aide when you have these types of services.


2) Hospice Care

Hospice services are much like VNA home care services in the way that they are reimbursed.  These companies get reimbursed by Medicare and Medicaid just like VNA home care services.

While their entirely different services, where they do overlap because they offer home health aides to provide specific tasks to get done.

Like a certified VNA home care company, the home health aides arrive for short periods of time to perform specific tasks.  So like VNA home care, there is no out-of-pocket cost for these services, there is not a whole lot of hours provided for the recipient of the care.


3) Private Home Care Services

Private home care is the types of services that Minute Women Home Care provides.

The benefits of private home care are you can have as many or few hours as you would like when you want them.  Private home care companies can provide few hours of care all the way up to 24/7.

The downside is it’s all out-of-pocket cost.  Insurances, private or Medicare/Medicaid do not reimburse for this.  It is only cash, credit or check as primary way families pay for the services. 

The downside is these costs can add up quickly but you have control over the caregivers provide care and for many adult children, the peace of mind that your parent is safe and that the care responsibilities are no longer entirely on their shoulders.


4) Private Private

Private private is when a family hires a private home health aide privately with no agency or office attached to the caregiver.   Hence the name, private private.

The benefit to this type of services is that it will save the family money while still providing one-on-one care services to the parent.

But there are some drawbacks to saving this money and hiring an aide privately.  

The first is there is usually no insurance associated with the caregiver.  So if the caregiver is injured on the job there’s no workers compensation to fall back on, you would personally be responsible for the caregiver’s bills and lost work time because of the injury. 

Also, there is no liability insurance so if the caregiver is to do something that would be negligent there’s nobody to compensate you for that service failure.

Another problematic situation that can occur is when a caregiver has an emergency themselves or within their own family.  You may get a call that they are no longer going to show up to care for your parent.  Or, in an even worse scenario, they never call you to let you know they are quitting the job.

So you are left scrambling trying to figure out who’s going to care for your loved one as there’s no office to call to find a replacement caregiver on short notice.

Finally, we need to talk about taxes.  While no one feels morally wrong about saving money and not paying taxes, if you get caught it’s a nightmare.

Since this arrangement is usually paid under the table, neither party is paying the taxes associated with having an employee/employer relationship.  As the employer, you should be paying statutory benefits and taxes for your employee.  It is a risk some people are willing to take.


Wrapping It Up

So there you have it in you now know the four different types of home care services that are out there.  Now you know what options you have when you are in different scenarios with your parent.

It can be challenging to understand the “lingo” that different industries use.  So when someone is talking to you about home care, determine what type they are talking about – the most common phrase being certified (reimbursed by Medicare) or private (not reimbursed by Medicare – out of pocket).