Paying for care, explained plainly

1. Private pay

The simplest route and the fastest to start. We bill by the hour for hourly care and by the day for live-in care, with a 4-hour minimum per visit and no long-term contract. You receive a written rate sheet after the free assessment and an itemized invoice every two weeks. Many families begin with private pay while a Medicaid or insurance application is in progress.

2. NJ FamilyCare (Medicaid) through MLTSS

Managed Long Term Services and Supports is New Jersey’s Medicaid program for people who need a nursing-home level of care but want to receive it at home. If the person qualifies financially and a nurse assessment confirms the need, their managed-care plan (for example Horizon NJ Health, Aetna Better Health, UnitedHealthcare Community Plan, Wellpoint or Fidelis Care) authorises a weekly number of home care hours and pays the agency directly.

Arie is set up to work with NJ FamilyCare managed-care plans. We help families start the application through the Essex County Aging & Disability Resource Connection and the county Board of Social Services, and we coordinate the nurse assessment.

3. Personal Care Assistant (PCA) services

People already on NJ FamilyCare Plan A who need help with daily activities, but not a nursing-home level of care, can ask their health plan for a PCA assessment. If approved, the plan authorises hours of personal care and an agency like Arie provides them.

4. The Personal Preference Program (PPP)

PPP is the self-directed version of PCA services. Instead of an agency, the person receives a monthly budget and hires the caregiver of their choice, which can be a family member, friend or neighbour. A fiscal intermediary handles payroll. Families often ask us which is better; the honest answer is that PPP gives control and agency care gives backup, training and nurse oversight. You cannot use both at once, and we will tell you plainly which fits.

5. Long-term care insurance

Most long-term care policies pay for in-home care from a licensed agency once the person needs help with two or more daily activities (or has a cognitive impairment) and the elimination period has passed. We help you read the policy, complete the claim, and submit the care notes and invoices the insurer requires.

6. Veterans and surviving spouses

The VA’s Aid & Attendance benefit adds a monthly amount to a wartime veteran’s or surviving spouse’s pension when they need help with daily activities. It can be used for home care. The Veterans Service Office in Essex County and accredited veterans’ organisations help with the application free of charge. Separately, veterans enrolled in VA health care may be eligible for Homemaker and Home Health Aide services through the East Orange VA Medical Center.

7. Other programs that help

• Jersey Assistance for Community Caregiving (JACC) provides in-home services to people at risk of nursing-home placement who do not qualify for Medicaid.
• Statewide Respite Care Program funds short breaks for family caregivers, through the Essex County Division of Senior Services.
• Medicare covers short-term skilled home health after a hospital stay but does not pay for ongoing personal or companion care. We work alongside Medicare home health agencies to cover the hours in between.