Quick Answer
Families usually pay for non-medical home care after discharge in one of four ways: private pay (fastest, often within days), long-term care insurance (starts the elimination period as soon as licensed care begins), VA Aid and Attendance (paid retroactively, but slow to approve), or Texas Medicaid STAR+PLUS (for eligible patients; can take months, and may involve an interest list). Medicare doesn't pay for ongoing non-medical care.
In This Guide
Key Takeaways
- →Medicare home health covers skilled visits only; ongoing non-medical help needs another funding source.
- →Private pay is the fastest and is often used as a bridge while other benefits start.
- →Ask every family about long-term care insurance; many don't think to mention it.
- →Starting with a licensed agency on day one starts the LTCI elimination period clock.
- →Specific functional language in the discharge summary supports insurance and benefit claims.
A patient can be medically ready to go home while the family has no idea how to pay for help once they get there. Discharge planners and case managers are often the ones who have to explain the options, usually with very little time.
This guide is a quick reference for the funding conversation: what each option covers, how long it takes, and what to document so the family's benefits actually pay.
Funding Options at a Glance
| Option | Who it fits | Typical timing | Notes |
|---|---|---|---|
| Private pay | Families able to pay out of pocket | Often within days of an assessment | About $25 to $35/hour in Houston; often a bridge |
| Long-term care insurance | Patients with an active policy | Claim approval in weeks; elimination period applies | Days count when care comes from a licensed agency |
| VA Aid and Attendance | Wartime veterans and surviving spouses with care needs | Approval often takes months; paid back to the claim date | Unrestricted monthly payment the family can use for care |
| Medicaid STAR+PLUS | Patients with limited income and assets | Can take months; interest list may apply | Uses providers contracted with the patient's health plan |
| Medicare home health | Homebound patients with skilled needs | Ordered at discharge | Skilled visits only; doesn't cover ongoing personal care |
Private Pay
Private pay has no approval process, so it's the fastest option. In Houston, non-medical care from a licensed agency generally runs $25 to $35 an hour. A patient who needs four to six hours of help each morning would typically pay about $3,000 to $4,500 a month at $25 an hour. Families can get an estimate from our rate calculator.
Framing tip: when families are worried about cost, describe private pay as a bridge for the first weeks while other benefits are set up, not a permanent commitment.
Long-Term Care Insurance
- Ask every family. Policies are often bought decades ago and forgotten.
- Benefit trigger: a licensed health care practitioner must certify a need for help with at least two activities of daily living, or a severe cognitive impairment.
- Elimination period: commonly 30 to 100 days. Days usually count only when care comes from a licensed agency, so starting licensed care at discharge starts the clock.
- Direct billing: an assignment of benefits lets the carrier pay the agency, so families aren't waiting on reimbursement.
Our guide to using long-term care insurance for home care walks families through the full process.
VA Aid and Attendance
Wartime veterans and surviving spouses who need help with daily activities may qualify for an increased VA pension that the family can use toward care. Approval often takes months, but payments go back to the date the claim was filed (or an earlier intent-to-file date), so families should start the paperwork early. See our Aid and Attendance guide.
Medicaid STAR+PLUS
For patients with limited income and assets (in 2026, up to $2,982 a month in income and $2,000 in countable assets for a single person), STAR+PLUS Home and Community Based Services can pay for personal attendant services at home. Patients already on Medicaid work through their health plan; others may be placed on an interest list through Texas Health and Human Services. It's rarely an option for immediate post-discharge needs. Our STAR+PLUS guide covers the steps. BlueBonnet does not accept Medicaid.
Discharge Readiness Checklist
- Daily activity needs documented in specific functional terms
- Family asked about long-term care insurance and VA service
- Funding source confirmed for the first two to four weeks
- Licensed home care agency arranged before discharge, not after arriving home
- Home checked for fall hazards, especially the bathroom
- Medication list and schedule given to the family and caregiver
- Backup contact and plan identified
Documentation That Helps Funding
Specific functional language in the discharge summary is one of the most useful things for a family's benefits. Insurance carriers and benefit programs look for what the patient can't do and what help they need, not just the diagnosis.
Less helpful: "History of Parkinson's disease."
More helpful: "Requires hands-on help to shower, dress and transfer from bed to chair due to tremor and unsteady gait; unsafe to walk without supervision."
Working With BlueBonnet
BlueBonnet Home Health is a licensed, non-medical home care agency serving Houston and the surrounding counties. We provide personal care, companionship, dementia support, and 24-hour and live-in care, paid privately or through long-term care insurance. For patients with a policy, we verify benefits with the carrier and bill the carrier directly. To discuss a patient or set up a referral relationship, call (346) 689-2339 or email admin@bluebonnetathome.com.
Frequently Asked Questions
Does Medicare pay for home care after hospital discharge?
Medicare home health covers skilled nursing and therapy visits for homebound patients who meet its requirements. It doesn't cover ongoing non-medical help such as bathing, dressing or companionship, which families usually pay for privately or through long-term care insurance.
What is the fastest way to start home care after discharge?
Private pay through a licensed agency is usually fastest, often within days of an in-home assessment. Families often use it as a bridge while long-term care insurance or other benefits start.
Does the LTCI elimination period start at discharge?
It typically starts with the first day of covered care from a licensed provider. Arranging licensed home care at discharge means those days can count toward the elimination period.
Can STAR+PLUS Medicaid start immediately after discharge?
Usually not. Eligibility and service setup can take months, and people not already on Medicaid may be placed on an interest list, so families typically need another source of care in the meantime.
What payment does BlueBonnet Home Health accept?
BlueBonnet accepts private pay and long-term care insurance, and does not accept Medicaid.
Related Reading
Discharge planners and case managers can reach us at (346) 689-2339 to discuss a patient or set up a referral relationship.
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