Coverage & payment
Understanding Home Care Coverage
One of the most common things families tell us is that they didn’t realize home care was covered— by their insurance, by their state benefits, or both. By the time they call us, many have already spent months paying out of pocket or going without support they were entitled to.
We want to change that. Here’s a simple breakdown of how home care is typically paid for in Pennsylvania.
Option 1
Medicaid Managed Care
If your loved one is enrolled in Medicaid in Pennsylvania, their plan may cover personal home care services at little or no cost to your family. Pennsylvania transitioned from the old state waiver system to managed care organizations (MCOs) that now coordinate and fund home care benefits for eligible members.
Golden Key Home Care is a credentialed provider with:
- Keystone First
- PA Health and Wellness
If your family member is enrolled in either of these plans, home care services may be covered— including personal care, companionship, meal preparation, medication reminders, and more.
How it works:
- The member’s MCO determines eligibility and authorizes hours of care
- Golden Key is assigned or selected as the provider
- We coordinate directly with the plan (your family doesn’t receive a bill for covered services)
Not sure which plan your loved one is enrolled in, or whether they qualify? We can help you navigate that conversation. Just call us.
A note on Medicare: Standard Medicare (Parts A and B) generally does not cover ongoing personal care or custodial home care services, things like bathing assistance, companionship, or meal preparation. Medicare home health benefits are typically reserved for skilled nursing or therapy services following a qualifying medical event.
If you have questions about what your Medicare plan does or doesn’t cover, your plan’s member services line is the best place to start. We’ll always be honest with you about what we can and can’t help with.
“Figuring out how to pay for care shouldn’t be harder than finding it.”
Eris Paja
Golden Key Home Care
Option 2
Private Pay
Families who prefer to arrange care privately (outside of insurance) are always welcome.
Private pay gives you maximum flexibility: you chose the schedule, the services, and the pace of care without waiting for authorizations. We’ll walk you through rates and what that looks like day-to-day during your first call.
Option 3
Long-Term Care Insurance
If your loved one has a long-term care insurance policy, it may cover in-home personal care services.
Every long-term insurance policy is different in terms of what triggers coverage and how benefits are paid. We recommend contacting your insurance provider directly to ask whether personal home care services qualify under your policy. We’re happy to provide any documentation they need from our end.
Start Here
Not sure where you stand?
You don’t need to have it all figured out before you call us. We understand the system and will tell you want your options are without any pressure.