Home Care in Delaware

According to the 2021 Genworth Cost of Care Survey, the average cost of home care in Delaware is $5,339 per month. In-home care offers non-medical services such as assistance with grooming, mobility, cleaning and other daily activities. Home health care provides skilled nursing, physical therapy and other medical services.

Delaware’s home care costs are higher than the national averages of $4,957 and $5,148, respectively. Delaware prices are also higher than most nearby states. The most affordable care in the area is Virginia, where seniors pay $4,767 for in-home care and $4,954 for home health care. In Pennsylvania, the average monthly fee is $4,957 for both care types, and in Maryland, both care types cost seniors $5,148 per month. New Jersey is the only neighboring state that’s less affordable than Delaware. Seniors there pay $5,529 per month for in-home care and $5,710 per month for home health care.

Older adults in Delaware can access a variety of senior care options to suit their individual needs and budgets. The most expensive option is nursing home care at $12,273. This high price reflects the around-the-clock care available in these facilities. Assisted living in Delaware is also less affordable than home care, with an average price of $5,995 per month. At $1,661 per month, adult day health care is the most affordable choice.

Delaware has moved away from using waivers for long-term care to providing assistance through a managed care model. This model is called the Diamond State Health Plan – Plus (DSHPP), and it covers the medical and non-medical care needs of recipients. This delivery model eliminates enrollment caps, meaning all eligible seniors can receive care, and it also reduces wait times to get services.

Home care is provided through a sub-program known as the Long-Term Care Community Services Program (LTCCS). It provides services to people living in the community, including those living at home, assisted living facilities and adult foster care. To be eligible for LTCCS, applicants must be at risk of nursing home placement if they don’t receive services.

When accepted into the program, participants develop a Plan of Care to determine what services they need. The exact services available depend on an individual’s circumstances but can include chore services, private-duty nursing, personal care and meal delivery. LTCCS may also pay for home modifications, durable medical equipment and personal emergency response systems.

The program allows for self-direction, so participants can choose their own caregivers. It may also pay some family members, including spouses and adult children, for providing care through LTCCS.

As Medicaid helps low-income people access health care, finances are its primary eligibility criteria. The income of single applicants can’t exceed $841 per month ($10,092 annually), and assets can’t exceed $2,000. Applicants in a two-person household can have a monthly income of up to $1,261 ($15,132 annually) and assets of up to $3,000. These limits are for regular Medicaid, and some programs may have different criteria.

Medicaid doesn’t count all assets when calculating eligibility. Exempt assets include personal belongings and an automobile. Your home is also exempt if you live there and its equity interest is below the state limit.

You can apply online for Medicaid using the ASSIST website. Forms are also available online in English and Spanish, and you can return them to the Department of Health and Social Services. Alternatively, you can request a form by calling Medicaid Customer Relations at (800) 372-2022. Seniors applying for Long-Term Care should contact their local Long-Term Care office.

What Information You Will Need

Medicaid staff may request the following information to assess your application:

• Birth certificate or INS alien forms/card
• Photo ID
• Social Security card
• Marriage certificate or divorce decree
• Power of attorney/guardianship papers
• Health insurance cards
• Proof of health insurance premiums
• Proof of resources such as titles to motor vehicles, account statements, trusts and life insurance policies

How to Get Help Applying for Medicaid

The intake unit interviews LTCCS applicants as part of the application process. Many people find their questions answered at this time; however, there are other resources available that can provide assistance.

Medicare doesn’t pay for non-medical home care, but it can cover the cost of the medical version of home care, called “Home Healthcare” in some situations. In order to be eligible, you need to be homebound and have a referral from your doctor for the specific type of medical care that is needed. There are also other restrictions that apply.

Below is an overview of some of the services typically covered by Medicare for those who are eligible:

• Physical Therapy: Physical therapy is used to help patients recover from injuries (broken bones, knee injuries, etc.), and to treat ongoing conditions such as arthritis. Additionally, physical therapy is often provided in the home to help seniors recover from surgeries and procedures, such as a knee or hip replacement.
• Nursing Care: Licensed nurses can provide a number of medical services (such as wound care, changing feeding tubes, etc.) for those who need medical care, but don’t need to stay in a hospital full-time.
• Occupational Therapy: Occupational therapy is designed to help seniors regain or maintain the ability to accomplish normal, daily tasks, such as bathing, dressing, eating, etc., and providers can travel to your home if needed.
• Speech Therapy: Seniors can lose the ability to adequately communicate for many reasons, and speech therapists are there to help seniors regain the ability to communicate using a variety of means. Additionally, speech therapists help to keep seniors independent by modifying diets and teaching special techniques to swallow safely.

As mentioned above, home care is distinctly different from home healthcare, but there is some overlap – so while Medicare doesn’t cover non-medical home care, there are personal care services that may be covered in special circumstances – such as an occupational therapist helping with eating or dressing.

Read our guide to Medicare and Home Care Coverage for more information.

While the above programs can be a great way to make home care affordable for many people, they are not the right solution for everyone. Thankfully, there are other ways to make home care more affordable for you and your family. For more information about your other options, read our section on Other Ways to Pay for this guide.

Older Delawareans who wish to age in place can find help through government and nonprofit organizations in the state. Seniors can access resources that include meals, transport and legal advice.

Per the Centers for Medicare & Medicaid Services (CMS) mandate issued January 28, 2022, all home care providers must have received their full COVID-19 vaccination by February 28, 2022, unless home care they qualify for an exemption. This rule applies to Medicare- and Medicaid-certified in-home care and home health care providers.

This advice is current as of April 2022; however, rules can change quickly. If you’re concerned about the vaccination status of people entering your home, your local Area Agency on Aging can give you information about the latest regulations. Home care agencies may also have more stringent rules for their staff. An agency representative can answer any questions about their vaccine and personal protection equipment (PPE) use policies.

In Delaware, it refers to agencies that provide home care as personal assistance services agencies. These agencies must comply with state rules and are licensed and overseen by the Office of Health Facilities Licensing and Certification. There are separate regulations and licensing requirements for home health care agencies that offer medical services. The following rules relate to non-medical care provided by personal assistance services agencies.

Whether you are looking for yourself or a loved one, finding a quality home care provider can be a stressful process. To help you overcome this challenge, we’ve created a helpful checklist below that can help guide you through the process of both determining your needs, and finding a home care agency that will be the best fit for you and your family.

Download PDF Here

Learn More About Home Care in Delaware’s Top Cities

• Wilmington