How home-care benefits and insurance may work

Many extended health benefit plans include some coverage for home care, but plans differ a great deal. A few questions to your insurer before care starts can save surprises later.

Questions to ask your insurer

• Does my plan cover home care, personal support (PSW) or nursing at home?
• Is there a yearly maximum, or a limit per hour or per visit?
• Do I need a doctor’s note or referral before care starts?
• Does the provider need to be registered with you?
• Can the provider submit the claim, or do I pay first and claim it back?

Documents a claim often needs

• A note or referral from a doctor or nurse practitioner, if your plan asks for one.
• Receipts showing the dates, hours, type of care and the provider’s details.
• Your plan and member numbers.

Other ways to help pay

Publicly funded home care in Ontario is arranged through Ontario Health atHome (310-2222). Private care can add to those hours. Some home-care costs may also qualify as medical expenses on your tax return; a tax professional can tell you what applies.

Coverage decisions are always made by your insurer under the terms of your plan. Tap’N’Care has provider relationships with GreenShield and Canada Life (providerConnect). For GreenShield, Tap’N’Care can submit eligible claims directly where your plan and the service permit. For other plans, we can help you understand what documentation your plan may require.