Does my insurance cover home care? - Carelancer
Skip to content

Resources / Careseeker

Does my insurance cover home care?

Finding the right insurance plan can be tricky. Each person has their own financial, logistical, and medical needs, and sometimes it feels almost impossible to find coverage that works for you. When weighing your options, it’s always best to begin by exploring the range of services available in your area.

Your first step, then, is to work out what’s covered by your provincial healthcare plan. Each province has its own plan that covers basic healthcare and dental services. It’s worth noting that home healthcare services are usually just a fraction of the cost of a retirement home. However, aging in place does come with a price tag, which is why it’s so important to begin looking into insurance policies that can lighten the load.
You may be asking yourself questions like: does the Ontario Health Insurance Plan cover home care costs? Do private insurance plans cover the cost for home healthcare? Does private healthcare insurance cover critical illnesses? The answers to these questions depend on a wide range of circumstances.

What type of home care is available?

Let's start by taking a look at the types of home care professionals available and what you can expect to pay for their services. Most home care professionals are either Personal Support Workers, Registered Practical Nurses, or Registered Nurses. Each provider’s rate will vary depending on their level of experience, the hours they expect to work (overnight care providers may charge a premium) and their specialties.

Personal Support Workers

They perform a variety of essential tasks to help people live as independently and comfortably as possible. Typical Personal Support Worker services include:

  • Bathing and personal hygiene
  • Medication reminders (but not administration)
  • Housekeeping
  • Meal planning, preparation, and feeding
  • Companionship
  • Grocery shopping
  • Transportation

In Toronto, Personal Support Worker rates generally start at 28$ per hour. Often there’s a minimum number of hours required per visit.

Registered Practical Nurses and Registered Nurses

Home care nurses can administer medications, change wound dressings, and provide tube feedings, amongst other services. If you or a loved one have acute or complex medical needs, a home care nurse is for you.

The main distinction between Registered Nurses and Registered Practical Nurses is their level of education. Registered Nurses tend to have a more comprehensive education which makes them better suited to complex situations.

On average, Registered Practical Nurses’ rates in Ontario start at $45 per hour, while Registered Nurses start from $55 per hour. Again, when providing these services, the healthcare professional will often require a minimum number of hours.
Many nurses decide to specialize. Some dedicate themselves to palliative care, some to ventilatory care. The more a nurse specializes, the higher their hourly rate.

Does the Ontario Health Insurance Plan cover home care?

So, how much of this will be out of pocket? The Ontario Health Insurance Plan covers partial to full payment for several healthcare services including:

  • Doctor’s appointments
  • Hospital visits and stays
  • Eligible dental surgery in hospital
  • Eligible optometry appointments (one eye exam per year if you’re under 20 or 65 and over – conditions apply)
  • Podiatry (foot health services)
  • Ambulance services
  • Travel for health services if you live in northern Ontario

The Ontario Health Insurance Plan covers partial to full payment for these services, but only after assessing factors such as household income, number of dependents, and the type of services required. This process is time-consuming and begins with a referral from the Home and Community Care Support Services. However, eligibility doesn’t necessarily mean that the Ontario Health Insurance Plan will cover the hours or services that you may need to continue living independently. And with public health insurance, your choice of providers is extremely limited.

For services covered under public insurance, you have little to no say over the frequency of visits or the regularity of your caregivers. Because of this, many prefer the freedom and flexibility of healthcare services that are covered through private insurance.

What is Community Care?

If you're not covered by Ontario’s Health Insurance Plan but still want to explore public options for you or a loved one, you could see if you qualify for Ontario's Home and Community Care Support Services. Ontario’s Home and Community Care Support Services connects you with government-funded support and home services that sometimes require co-payment. To assess your eligibility, you will undergo a screening process involving a home visit from a case worker. The organization then selects your provider.

What are the financial assistance programs available for seniors aging at home?

Various grants and tax credits are available to help reduce the financial strain of home care. These programs provide financial assistance to help cover the costs of home modifications and other services that support aging in place.

Eligibility for the program varies depending on the province, but it typically depends on your income, assets, and level of need. To learn more about the programs available in your province, you can reach out to your local government or a non-profit organization that specializes in aging services.

Explore more information about your local services for aging at home by checking out the links below:

Does private insurance cover home health care?

Most private healthcare plans include some form of home care coverage that isn’t covered by the Ontario Health Insurance Plan. Significantly, private insurance often provides you with a greater choice of caregivers.
Of course, when you or a loved one are approaching retirement, you can consider more specific private insurance plans for either long-term or critical illness care. Long-term insurance will cover ongoing care for you or a loved one at home or in a nursing facility, helping pay for services you might need including hygiene and bathing assistance, medication reminders, and meal preparation.
However, critical illness insurance provides you with a one-time payment to cover your medical expenses in the event of a serious or chronic health condition. Here are a few things to bear in mind when weighing your options.

Long-term care insurance

Private long-term care insurance enables you to stay living in the comfort of your own home. This has innumerable benefits. In fact, recent studies have shown that people who age in place not only maintain a sense of independence, but also live longer as they feel empowered to preserve their lifestyle and routine.

In a typical long-term home care scenario, friends and family members often take it upon themselves to care for their loved one. However, this can be extremely challenging. Especially if these nonprofessional caregivers are in full-time employment or have other financial or family commitments. Private long-term care insurance relieves your loved ones of this pressure, and helps you find peace of mind in the knowledge that your care will be covered, no matter what

Critical illness insurance

Private critical illness insurance protects you and your loved ones from debt and income loss in the event of a serious or chronic health condition. It also broadens your access to medication and experimental treatment options that are not covered by the Ontario Health Insurance Plan. This is an insurance option worth considering if you or your family members have a history of ill health. Remember, critical illness insurance is paid out as a lump sum which you can spend as you see fit.

Invest in yourself, now and in the future

As you navigate the complexities of home care, it’s important to take the time to assess your needs for the present as well as the future. Work with a service provider who can meet your current needs. And ensure that you keep abreast of ongoing changes in your condition so that your coverage suits your evolving medical needs.
For skilled home care professionals at your fingertips, look no further. Carelancer connects you with professional caregivers for all your home care needs. No matter your income, location, or schedule, find certified caregivers that provide specialized care, whenever and wherever you need.