On this page
- Executive Summary
- What Private-Pay Home Care Covers
- Long-Term Care Insurance
- Comparison: Private Pay vs. Long-Term Care Insurance vs. Combining Both
- How Short-Term Skilled Care at Home Fits In
- A Decision Framework for Planning Ahead
- What This Means for Families
- Frequently Misunderstood Issues
This article provides general educational information about paying for home care and is not individualized financial, insurance or legal advice. Policy terms vary; confirm details with your insurance carrier or a licensed advisor.
Executive Summary
Most New York families pay for ongoing, non-medical home care (help with bathing, dressing, meals, supervision, overnight or live-in support) privately, through a long-term care insurance policy, or with a combination of the two. Understanding how a long-term care insurance policy pays for home care, and planning private-pay hours around a real household budget, are the two decisions that shape most care plans.
What Private-Pay Home Care Covers
Private-pay home care, provided through a licensed home care services agency (LHCSA) such as Angels on Call Homecare, is flexible: a few hours a week, daily visits, overnight care, 24-hour care or live-in care, adjusted as needs change. The family (or a long-term care insurance policy) pays the agency directly, and the agency is the employer of record, handling screening, training, payroll, insurance, supervision and backup coverage.
Long-Term Care Insurance
What it typically covers
A long-term care insurance policy is generally designed to pay for ongoing personal and custodial care, the kind of daily help with activities of daily living that many aging adults need at home. Many policies include a home care benefit, but terms differ from policy to policy.
What to check in an existing policy
- The daily or monthly benefit maximum, and any lifetime maximum
- The elimination period (the waiting period before benefits begin) and whether it counts calendar days or days of paid care
- Benefit triggers, usually needing help with a set number of activities of daily living or a cognitive impairment such as dementia
- Whether home care (not only facility care) is covered, and whether care must come from a licensed agency
- Paperwork the carrier requires: plan of care, care notes, invoices, and how often claims are filed
Working with the insurance carrier
Call the carrier early, before care starts if possible, to open a claim and confirm what documentation it needs. Angels on Call Homecare accepts private long-term care insurance from carriers such as Genworth, John Hancock, CNA and MetLife; families still pay any amount the policy doesn't cover.
Comparison: Private Pay vs. Long-Term Care Insurance vs. Combining Both
| Approach | Best suited for | Flexibility | Key thing to plan for |
|---|---|---|---|
| Private pay | Families who want to start quickly or need hours a policy won't cover | Fully flexible hours and duration | A realistic monthly budget and how long it can be sustained |
| Long-term care insurance | Families with an existing policy that includes a home care benefit | Within the policy's benefit maximums and terms | The elimination period, benefit triggers and claim paperwork |
| Combining both | Families whose needs exceed the policy's daily benefit | Policy pays up to its limit; private pay covers the rest | Coordinating invoices and documentation each month |
How Short-Term Skilled Care at Home Fits In
After a hospital stay or a change in health, a physician may order short-term skilled nursing or therapy at home. That care is provided by a certified home health agency (CHHA) (NYS Department of Health: Home Care information for consumers) in intermittent visits, and it is separate from ongoing private-pay home care. Angels on Call Homecare works alongside CHHAs, and alongside hospice and palliative care providers, so the daily support at home and the skilled visits stay coordinated.
A Decision Framework for Planning Ahead
Start by identifying the level of care actually needed (see our guide to how much homecare a parent needs). Then work through four questions: Is there a long-term care insurance policy, and does it include a home care benefit? How long is the elimination period, and how will care be paid for during it? How many hours a week will the policy cover, and what will be private pay? How will the plan change if needs increase?
What This Means for Families
The most useful first step is usually a conversation that maps the care need to the budget and to any policy already in place. Angels on Call Homecare is a private-pay agency that accepts private long-term care insurance; its team can walk a family through how private-pay hours and a policy's home care benefit fit together. Call 845-628-2255.
Frequently Misunderstood Issues
Families often assume a long-term care policy starts paying the day care begins. Most policies have an elimination period, and families commonly pay privately during it. Another common assumption is that a policy covers any caregiver; many policies require care from a licensed agency, which is worth confirming before hiring privately (see hiring a caregiver privately in New York).
This article is educational and is not legal, tax, or financial advice. Employment, tax, and insurance rules change; consult a qualified attorney, accountant, or licensed advisor about your situation.
Sources
- NAIC, A Shopper's Guide to Long-Term Care Insurance
- NYS Department of Health, Home Care: Information for Consumers
- NYS Department of Health, Licensed Home Care Services Agencies (LHCSAs)
FAQ Schema Indexed
Frequently asked questions
How do most families pay for ongoing home care in New York?+
Most families pay privately, through a long-term care insurance policy, or with a combination of the two. Private pay offers the most flexibility; a long-term care insurance policy can offset much of the cost when it includes a home care benefit.
Does long-term care insurance pay for care at home?+
Many policies do, but terms vary. Check the home care benefit, the daily or monthly maximum, the elimination period, and whether care must come from a licensed agency.
What is an elimination period?+
It's the waiting period between when a person qualifies for benefits and when the policy starts paying. Depending on the policy it may count calendar days or only days on which paid care was received.
Does Angels on Call Homecare accept long-term care insurance?+
Yes. Angels on Call Homecare is a private-pay agency and accepts private long-term care insurance from carriers such as Genworth, John Hancock, CNA and MetLife. Families pay any portion the policy doesn't cover.
Who provides skilled nursing or therapy at home after a hospital stay?+
Short-term skilled nursing and therapy ordered by a physician are provided by a certified home health agency (CHHA). Angels on Call Homecare works alongside CHHAs, hospice and palliative care providers, providing the ongoing daily support around those visits.
Can private pay and long-term care insurance be combined?+
Yes. Many families use the policy up to its daily or monthly limit and pay privately for additional hours.
About the Author
Eric J. Dalton
Vice President, Angels on Call Homecare
CDES · CDCP · Dementia Care Specialist · Montessori Dementia Capable Certification · Teepa Snow Inspired Certification · CPDC · Parkinson's Foundation Site Champion · Aging in Place Essentials Professional
Dementia and Parkinson's care strategist, systems thinker, and advocate for dignity-centered aging at home. Through Aging in Place Redefined and leadership at Angels on Call Homecare, his work focuses on redefining advanced, emotionally intelligent, clinically guided care at home for families navigating cognitive and neurological conditions.
Written and reviewed by Eric J. Dalton. Last reviewed Sep 9, 2026. See full credentials
