What Is the Difference between Private Duty Care & Medicare?

As the occurrence and severity of diseases are increasing day by day, medical health care demand is also skyrocketed. Likewise, the cost of healthcare services has also escalated over the past few decades. Therefore, there is a significant shift towards the use of private duty home healthcare agencies. While private duty care’s essential services are somewhat similar to the Medicare and Medicare-funded home care services, there are several differences, such as in their mode of payments, service delivery, revenues, and overall customer experience. 

In this blog article, we will discuss in detail the definition and description of private duty home care, Medicare, and Medicaid and the significant differences among them so that you get the best idea of which care option fits the best for you or your loved one.   


What is Private duty home care?

Older adults, disabled clients, or those who need assistance in recovery from an illness or injury often seek private duty home care services. This form of care is provided through an agency or directly from a private caregiver.

Private duty care is a type of home care delivered on a private pay basis, Which means that clients or their loved ones pay to the private home care agency or caregiver. The clients’ care program or needs vary based on their illness type, so private duty care gives this leverage where people can customize their plans based on their requirements and meet their unique needs. 

Clients who opt for a private duty home can access as much support as they need without seeking approval from primary care physicians or medical professionals. With private duty care, you do not need to comply with any eligibility requirement. Instead, you are free to choose the service on a short-term or long-term basis.

Another significant contrasting factor for private duty home care is that they have the flexibility to match caregivers with clients based on skills, preferences, and overall compatibility. Therefore, it leads to a high level of client satisfaction, which ultimately helps to increase profits. 

What do Medicare and Medicaid do?

In contrast to private duty home care, Medicaid and Medicare are government-funded health insurance programs for senior citizens 65 years or older and eligible people with disabilities. Medicare Part A (hospital) and Medicare Part B (medical) cover some home health services such as intermittent skilled nursing care, occupational and physical therapy, medical social work, speech therapy, and limited personal care. 

Medicare and Medicaid provide limited coverage for home healthcare services under specific circumstances. Similarly, the benefits are delivered through agencies that are contracted with the government. Note that the service availability varies in each state and is subject to change each year.

Many states use Medicare or Medicaid-funded home care services to delay or reduce institutionalization rates among medically-fragile seniors and people with disabilities. According to Genworth’s 2019 Cost of Care Survey, the national median cost for nursing home care in a private room is $8,517, while home health aide and homemaker services cost $4,385 and $4,290, respectively. 


What is the difference between private duty care and Medicare?

There are many differences between private duty home care services and government-funded home care services.

As per the client’s perspective, qualifying for Medicare or Medicaid-funded home care services is not easy. Instead, there are strict eligibility criteria that must be met. The Medicare or government-funded home care client has no say in choosing their caregiver, the frequency of services, and the carer’ to the client. In fact, in most cases, the Medicare and Medicaid services are time-bound, which means that the clients who require long-term care need to re-qualify for services frequently.

Not only that but medicare and Medicaid-funded agencies often have to deal with significant financial and logistical barriers that restrict their tendency to achieve and maintain profitability. They usually provide services at a low cost, so it often means that they may not choose the services they need. 

There are also strict regulations around the type of care that government-contracted caregivers can deliver, which further stresses the clients, their families, and caregivers while leading to conflicts between the provider and the client. For instance, Medicare will not cover primary care services such as meal assistance or companion care, which are often vital to seniors’ health and well-being and people with disabilities.

On the contrary, private duty care offers many advantages. First, they are free to provide a broad range of non-medical services to their clients, such as personal care, companion care, and other forms of services. Further, private duty care providers also offer 24/7 care upon request, which means increased revenue and better service delivery for clients who want to use home care services as an alternative to a senior care facility. 

To learn more about the differences between private duty home care and Medicare/Medicaid funded home care service delivery, contact Preferred Gold. It is one of the best private duty home care service providers in the United States.