How do you pay for your home health aid?

[jkalter]

I've been trying to figure out how to get insurance to pay for my home health aid. I've got a Blue Shield PPO, and my current home health aid does not work for one of their preferred agencies. To get coverage, either I'd have to switch to someone else, or she'd have to switch agencies. Neither option seems worthwhile unless I can get insurance to cover a substantial portion of my cost.

The policy states that they cover 70% of the cost of home health care, up to a maximum of 180 hours per year. My home health aid works 38 hours/week at $15/hour. So, the total value of this insurance benefit is $1,890/year, whereas my cost is $27,300/year. The Blue Shield representative said that I might be able to increase the amount they cover by making an argument that home health care is a medical necessity.

To top it all off, I haven't even been able to get a list of the Blue Shield preferred home health agencies in my area. When I inquired, they said "Tell us what agency you're interested in, and we'll look up whether they're on our provider list."

What's a quad to do? Has anyone had any experience with this particular battle that they'd like to share? Any insights you have would be greatly appreciated.

Thanks,

Jill