The topic of long-term care is one that comes up frequently when I talk with clients. With the aging population in the United States steadily rising, clients are interested in ways to prevent the need for long-term care and strategies for financing it when it becomes unavoidable. Many people are unaware of the diverse options accessible to support seniors requiring assistance but who are not yet at the point where nursing home care is necessary. One of those options is home health services. Allow me to provide a brief overview of your home health care options in Maryland to help you decide if home health care is the right choice for your situation.
What Is Home Health Care?
In the United States, a substantial portion of the elderly population, approximately 3.6 million out of nearly 40 million seniors, are considered homebound and require assistance within their residences. While the demand for caregiving services for seniors is high, not all require the constant supervision provided by nursing homes, and many cannot afford the considerable expenses associated with such facilities (which averaged over $130,000 per year in 2025). This creates a significant incentive to explore alternative caregiving options that allow seniors to remain in their homes. One such alternative is in-home health services, also referred to as home health care. These services are administered directly to the patient’s home by licensed medical professionals, including nurses, therapists, and aides, offering skilled care to treat or manage illnesses, injuries, or medical conditions. It is important to distinguish between health care and home care, with the latter typically involving assistance with tasks of daily living such as bathing and cooking that is provided by unskilled caregivers.
Home Health Services Are Underutilized
A study published in the Journal of American Medical Directors Association in 2023 examined the utilization of home-based clinical care and long-term services and supports (LTSS) among older Medicare beneficiaries to assess the frequency of in-home health services utilization. Analyzing Medicare claims from 974 beneficiaries, the study found that while homebound individuals did use these services, no group received high levels of all types of care. Homebound seniors utilized LTSS services more frequently (80 percent) than home-based clinical care (30 percent), indicating a significant gap between seniors who could benefit from in-home health services and those currently receiving them. Three distinct levels of in-home clinical care and LTSS usage among older adults were identified by the study, including:
- Low Care and Services (46.6 percent): The largest group received minimal home-based care, and these individuals tended to be younger with fewer chronic conditions and functional impairments.
- Home Health Only with LTSS (44.5 percent): This group utilized some home health services, such as assistance with activities of daily living (ADLs) but received little home-based clinical care.
- High Clinical with LTSS (8.9 percent): A small number received extensive home-based clinical care, and they were generally older, more likely to have dementia, and lived alone.
Will Medicare Cover Home Health Care?
When it appears that long-term care may be needed, options should be considered as well as the cost of those options. The expense of a LTC facility can be prohibitive and Medicare does not cover long-term care. While Medicaid does cover the cost of LTC, you must first qualify for benefits. What you may not realize, however, is that Medicare may help cover the costs associated with home health services. Medicare Parts A and B may cover medically necessary part-time or intermittent skilled nursing care, health assistance, durable medical equipment, and medical supplies for use at home. Part A covers home health care for individuals following a hospital stay or a stint in a skilled nursing facility, while Part B provides home health care for homebound adults in need of skilled nursing care. Medicare deems an individual homebound if they have difficulty leaving their home due to illness or injury, their physician recommends staying at home, and leaving their residence requires significant effort, such as the use of a cane, wheelchair, walker, crutches, special transportation, or assistance from another person. Medicare will not pay for 24-hour a day assistance nor for a home care assistant; however, you may qualify for a home care assistant through the Maryland Department of Human Services.
Do You Have Additional Questions About Home Health Care?
For more information, please contact our estate planning office in Owings Mills, Maryland by calling 410-654-3850 to schedule an appointment.
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