Homecare and Health Insurance

By Krista DeKuyper | June 8, 2015 | Employee Benefits, Health Insurance

Introduction

This blog article discusses home care, with a special emphasis on homecare and health insurance coverage offered via Canadian health insurance plans.

We first discuss homecare in general, and then examine homecare services benefits offered by two main types of health insurance: employee benefits plans and individual health insurance plans.

We finish off the article by also discussing free homecare services available through various support agencies.

What is Homecare?

“Homecare” is assistance a person receives with various duties that they can no longer safely accomplish themselves. Oftentimes these are services in the home, although this is not always necessarily the case.

When people hear the phrase “homecare” it is most often associated with nursing services. There are more homecare services other than nursing, however, that people need help with.

Generally speaking homecare services can be categorized as Daily Activity assistance, Personal Care assistance and Palliative Care assistance.

Examples of Daily Activities Services:

  • Preparation and planning of meals.
  • House cleaning (usually tidying up as opposed to major cleaning).
  • Assistance with activities out of the home such as banking, grocery shopping, etc.
  • Help with getting around the home.
  • Getting dressed and undressed.

Examples of Personal Care Services:

  • Bathing.
  • Feeding.
  • Grooming.
  • Any necessary rehabilitation exercises.
  • Medical assistance (e.g. changing bandages).

Examples of Palliative Care Services:

  • Help with IV (intravenous) therapy.
  • The administration and monitoring of pain killers (e.g. morphine).
  • Assistance with an oxygen machine.

Note that these services are often, but not always, provided by a registered nurses (RNs). For example, Personal Support workers also perform various home care duties.

Employee Benefits and Homecare Coverage

Most employee benefits plans (also referred to as “group health insurance” or “group insurance”), provide homecare and nursing benefits.

Coverage is usually extensive, ranging from $10,000 to $15,000 per year in coverage.

Services that are covered can be full-time care, part-time care or occasional care.

Also, homecare and nursing services claims do not have a major impact on claims experience (i.e. lots of claims will not result in major premium increases).

Individual Health Insurance and Homecare Coverage

Many individual health insurance plans (also referred to as “personal health insurance” or “family health insurance”) provide coverage for homecare and nursing services.

Please refer to the following to compare and contrast homecare and nursing services coverage offered by leading Canadian personal health insurance plans.

Plan Coverage Amount
Flexcare – ComboPlus Starter Plan
(Manulife)
– Year 1: $1,000 per year per person
– Year 2: $1,300 per year per person
– Year 3: $1,500 per year per person
– Year 4: $1,700 per year per person
– Year 5: $3,000 per year per person
Flexcare – All Other Plans
(Manulife)
– $3,500 per year per person (64 and younger)
– $4,000 per year per person (65 and over)
Blue Vision Global
Regular & Enhanced plans
(Ontario Blue Cross)
$2,500 per year per person
PHI
Basic Plan
(Sun Life)
– $2,500 per year per person
PHI
Standard Plan
(Sun Life)
– $5,000 per year per person
PHI
Enhanced Plan
(Sun Life)
– $10,000 per year per person
Sonata Scale 1
(Great West Life)
No
Sonata Scale 2
(Great West Life)
– $3,500 per year per person
Sonata Scale 3, 4, 5, 6
(Great West Life)
– $5,000 per year per person
FollowMe Basic Plan
(Manulife)
– Year 1: $500 per year per person
– Year 2: $750 per year per person
– Year 3: $1,250 per year per person
FollowMe
Enhanced and EnhancedPlus Plans
(Manulife)
– Year 1: $1,000 per year per person
– Year 2: $1,500 per year per person
– Year 3: $3,000 per year per person
Blue Vision Express
(Ontario Blue Cross)
– 80% coverage*, $2,500 per year per person

 * All other plans pay out at 100%

Free Homecare Services

There are various organizations that do provide free homecare and nursing services to people who struggle financially.

Oftentimes these organizations are run locally but funded provincially.

If you or someone you know needs free homecare and nursing services please contact your local government for assistance. You can also do an online search for “mytown homecare services”.

Conclusion

We hope you found this blog article about homecare and nursing services helpful.

Feel free to leave a comment below or contact us if you have any questions, as licensed Canadian insurance brokers we are here to help!