4 Ways to Maximize Your Alberta Health Services Home Care Benefits

Navigating Alberta’s health care system can be tricky, especially when trying to secure the maximum support for yourself or a loved one. Luckily, Alberta Health Services offers two key programs—Self Managed Care and Client Directed Home Care Invoicing—that help cover the cost of home care. Understanding how these programs work and how to navigate the assessment process is key to getting the support you deserve.

What Programs Are Available?

• Self Managed Care: This program gives you flexibility in hiring your own caregivers, offering $25.65 per awarded hour. However, it comes with added responsibility—you’ll need to manage schedules, payroll, taxes, and reporting to AHS each quarter. These tasks are complicated and time-consuming.
• Client Directed Home Care Invoicing: A simpler alternative to Self Managed Care, this program allows you to choose from a list of approved home care providers. The home care provider bills Alberta Blue Cross directly at $33.61 per hour, and they handle staffing and record-keeping, so you don’t have to.

Who is Eligible?

Any Alberta resident with a valid health care card whose needs can be safely met at home may be eligible. The level of funding you receive depends on your AHS Home Care assessment, which evaluates your needs to determine how many hours you are awarded. Applicant income and financial standing are not considered in the assessment.

Now that you know the basics, let’s talk strategy. Here are four ways to ensure you’re awarded the maximum home care hours possible.

1. Do Your Homework—Know What the Assessment Looks For

Preparation is everything. Before you meet with your Alberta Health Services case manager, it’s important to understand how they will assess your needs. Part of the process involves the RAI assessment, a standardized tool used to evaluate your ability to manage daily activities, cognitive health, medical conditions, mental well-being, and social support. This assessment is comprehensive and evaluates:

• Functional status: Ability to perform activities of daily living (ADLs) like dressing, eating, mobility, and bathing.
• Cognitive status: Cognitive impairment, memory, decision-making abilities.
• Medical conditions: Diagnoses, comorbidities, and any special care needs.
• Mental health: Depression, anxiety, or other psychiatric concerns.
• Social support and environment: Availability of family or community support.

Each category is scored, and these scores determine the type and amount of support included in your care plan. For example, a high score in functional status would indicate a greater need for personal care hours. The RAI assessment is not exclusively used for home care, and certain combinations of needs may actually push you towards placement in an assisted living retirement home. Understanding this process puts you in control. Take the time to learn how the assessment works so you can make sure your case manager has a full picture of your needs.

2. Prepare Thoroughly—Details Matter

Going into your assessment unprepared can lead to missed details and, ultimately, fewer hours of care. That’s why HomeFree offers pre-assessment support. Our Care Professionals will spend time with you beforehand to create a daily activity log that highlights your challenges and tracks the little things that often go unnoticed.

We also make sure your family and caregivers are heard—they often spot things you may not notice. We’ll conduct thorough interviews, gather input, and compile everything into a report that ensures your case manager has a complete and accurate understanding of your situation. You won’t be caught off guard or leave the assessment feeling like something was missed.

Get Pre-assessment Support

3. Advocate for Yourself—Speak Up During the Assessment

This is your opportunity to ask questions. Don’t hesitate to inquire about how your needs are being assessed—ask specific questions like, “How much time am I being awarded for help with showering?” There’s a range of time that can be awarded for different tasks, and the answers can help you spot discrepancies to ensure your needs are properly reflected in the final decision.

4. Request a Reassessment—Your Care Needs Can Change

Your needs aren’t static—they change as you age. That’s why it’s crucial to stay proactive and request a reassessment if your condition worsens. Don’t assume the care hours you were awarded initially will always be enough. A reassessment can help you secure more hours and better support.

It’s important that your home care provider keeps a record of any changes in your abilities, as this documentation can strengthen your case for additional hours. At HomeFree, we stay proactive, tracking changes in your daily activities so we can help you request a reassessment when needed.

Get the Support You Deserve

Maximizing your Alberta Health Services home care benefits isn’t about working the system—it’s about getting the care you need to live comfortably and independently. With the right preparation and advocacy, you can secure the hours you deserve. At HomeFree, we make this process simple so you can focus on living life on your terms.

HomeFree Care Company is an approved vendor with Alberta Health Services and eligible for direct billing through Alberta Blue Cross.

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