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In-Home Nursing / Home Care

In-home nursing, also known as home care nursing, covers professional medical services delivered in your residence by a registered nurse (RN), licensed practical nurse (LPN), or registered practical nurse (RPN). This benefit supports individuals recovering from illness, surgery, or long-term conditions who require medical supervision outside of a hospital.

Coverage typically includes nursing assessments, wound care, injections, medication administration, and other treatments prescribed by a physician. Most plans limit reimbursement to a set dollar amount per year, and some require pre-authorization before services begin.

Example:

If your plan covers up to $10,000 per year for in-home nursing and you receive services costing $9,200, the insurer reimburses the full amount up to your limit.

What to Watch For:

Obtain a doctor’s note or pre-authorization before care starts. Plans may not cover non-medical home assistance unless listed under home support services.

Related Terms

Individual Insurance

Individual insurance is a personal policy purchased directly from an insurance company to provide financial protection for a single person or family, rather than through an employer or group plan. It allows you to customize coverage according to your health needs, lifestyle, and budget. Common types of individual insurance include health, dental, life, critical illness, and disability coverage.

Insured Person

An insured person is the individual covered under an insurance policy who is entitled to receive benefits for eligible claims. In a personal policy, the insured person is typically the policyholder who owns the coverage. In a group insurance plan, the insured person is the employee or member enrolled in the plan, and their eligible dependents may also be covered under the same contract.

Insurer

An insurer is the insurance company or organization that provides financial protection to individuals or groups in exchange for premium payments. The insurer assumes the risk of potential loss and agrees to pay benefits for covered claims according to the terms of the policy. Insurers evaluate applications, determine premiums, issue policies, and manage claims through underwriting and administration processes.

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