Custodial care helps individuals with their daily living activities and basic care needs. Usually, it is recommended by a health professional and primarily involves non-medical assistance on a daily or ongoing basis.
Suppose custodial care is something you may require. In that case, it’s important to know how your health insurance will provide coverage, especially if you have Medicare.
What is Custodial Care?
Simply put, custodial care involves non-medical care for seniors. Usually, seniors under custodial care have a chronic condition where there is a high chance of not making a full recovery. It includes daily living and basic care activities such as bathing, grooming, dressing, eating, and ambulatory assistance. Generally, custodial caregivers are not mandated to be trained medically as they offer basic care services.
Custodial caregivers may also offer some housekeeping services in some cases. Though custodial care providers commonly work in senior facilities, they often provide at-home basic care services for seniors.
Does Medicare Cover Custodial Care?
Generally, Medicare does not cover custodial care as it involves non-medical care. There is no coverage for activities of daily living under Medicare.
However, if the beneficiary needs short-term care at a nursing home due to an illness or injury, Medicare will cover the necessary health costs. Custodial care coverage is not available under Original Medicare and Medicare Advantage. However, beneficiaries may get limited short-term custodial care under short-term home care in Medicare Advantage plans.
Medicare only covers services that are deemed medically necessary and the services must be provided by a healthcare provider authorized by Medicare. If a Medicare beneficiary requires in-home healthcare or short-term home care under a Medicare Advantage plan, the approved home healthcare agency can provide limited custodial care services alongside the required healthcare services.
Custodial Care vs. Skilled Nursing Care
Custodial care is largely different from skilled nursing care. Medicare covers skilled nursing care but does not cover custodial care. Skilled nursing care is meant for seniors who need medical assistance while recovering from an injury or a medical procedure. Seniors who are receiving palliative or hospice care may also need skilled nursing care. Hospice care is also covered under Original Medicare.
Skilled nursing care involves nurses who are medically trained and licensed to provide certain medical services to seniors and other patients. Skilled nurses can care for wounds, administer drugs, and provide physical therapy. However, custodial caregivers are not required to have medical training or offer medical services under skilled nursing care. Some long-term insurance plans may include custodial care coverage. For example, VA benefits cover a large part of custodial care services.
Custodial care example
One diagnosis that would probably need Custodial care is Alzheimer`s disease. With all the medical care needed for people with Alzheimer`s disease, there is a lot of non-medical care that is really necessary. Alzheimer`s patients have a tendency to wander and because of that usually have a need for only custodial care. Regarding the stage of progression of Alzheimer`s disease, here are the most common everyday tasks that a person diagnosed with Alzheimer`s will need:
- Using the phone or other communication item
- Daily shopping
- Regularly paying bills
- Making or ensuring a meal
- Doing laundry and cleaning
- Help with regular medication use
- Transportation
In middle-stage and late-stage of Alzheimer`s disease, with all tasks stated up, a person will probably need help with personal care as well, including:
- Bathing
- Going to toilet
- Dressing properly for the current weather outside
- Eating
- Getting in and out of bed, chair, etc.
To know more about how Medicare provides coverage for seniors, contact us today at 417-633-7200.