Market reference guide: This article covers information from both Korea and the United States. Each piece of information is marked as 🇰🇷 Korea or 🇺🇸 U.S. in the text to indicate which country's standards apply.
"A nursing facility feels too soon, but leaving them alone feels worrying." Many Korean-American families feel uncertain at precisely this juncture. How wonderful it would be if parents could remain in their familiar home while receiving the help they need. In-home care systems are what bridge that wish to reality. Both Korea and the United States have public support frameworks in place, but their structures and conditions differ substantially. By examining the two systems side by side, families can gain much clearer insight into what preparation they should undertake.
🇰🇷 Korea In Korea, public support for in-home care operates primarily through the Long-Term Care Insurance for the Elderly. This system is a social insurance that provides benefits such as physical activity assistance and household task support to individuals aged 65 and over, or those under 65 with elderly-related diseases—those for whom it has been difficult to manage daily living independently for six months or longer due to advanced age or conditions such as dementia, cerebrovascular disease, or Parkinson's disease. After applying through the National Health Insurance Service, the Rating Determination Committee assigns grades from 1 to 5 and a cognitive support grade. According to the 2024 Long-Term Care Insurance Statistical Yearbook published by the National Health Insurance Service, as of 2024 the number of approved applicants was 1.165 million, a 6.1% increase from the previous year, and approximately 11% of elderly persons aged 65 and over benefit from this system.
🇰🇷 Korea Once approved, recipients can choose between two broad forms of benefits. In-home care benefits involve a caregiver visiting the home to assist with meals, bathing, cleaning, nursing care, and related tasks; attending adult day care or overnight care centers; or renting or purchasing assistive devices. Facility benefits involve admission to a nursing home to receive care. In principle, grades 1 and 2 can use both facility and in-home benefits, while grades 3 through 5 can use only in-home benefits. However, in cases where family caregiving is difficult or where behavioral problems from dementia are severe, families may apply through review to switch to facility benefits. In 2024, total long-term care benefit expenditure reached 16.1762 trillion won, breaking through 16 trillion won for the first time. In-home care benefits accounted for 9.2412 trillion won, a higher share than facility benefits. When using in-home care, the out-of-pocket share is 15% of total costs; for facility care, it is 20%. Persons receiving basic livelihood assistance have no out-of-pocket costs, and those with lower income see reduced rates of 6% to 12%.
🇺🇸 U.S. In the United States, the primary pathways for persons aged 65 and over to receive in-home care through public insurance are Medicare and Medicaid. Medicare (Parts A and B) offers "Home Health" benefits, but eligibility conditions are strict. A physician must formally certify that the person is "homebound," and the care must involve medically necessary skilled services such as intermittent specialized nursing or physical or speech therapy. Medicare does not ordinarily cover situations where only custodial care—such as bathing assistance or meal preparation—is needed. As of 2025, the standard monthly Medicare Part B premium is $185, and as of 2025, 68.9 million Americans are enrolled in Medicare.
🇺🇸 U.S. Elderly persons with income and assets below certain thresholds may receive home care support through Medicaid. As of 2025, the Medicaid home and community-based services (HCBS) income limit is $2,901 per month, and the asset limit is $2,000. More than 30 states support receiving care at home instead of in a facility through Medicaid waiver programs, and Medicaid covers more than one-third of total home care expenditures. The number of "dual eligible" beneficiaries receiving both Medicare and Medicaid is 13.7 million as of 2024; in such cases, Medicare applies first and Medicaid covers the remaining portion.
[한국·미국] Both countries show a clear preference for aging in place rather than in institutions. According to an AARP survey, 88% of adults aged 50 and over wish to remain in their own home as long as possible. Korea likewise shows a steady increase in the proportion using in-home care benefits. However, in both countries the systems are complex, application procedures and eligibility conditions are strict, and families who do not study them in advance often miss out when the need actually arises. For Korean-American families living in the United States in particular, the combined barriers of language and unfamiliarity with the system can compound difficulties.
Regardless of which country you live in, the starting point for using in-home care systems well is to first clearly understand your parents' current health condition and the level of support they need. 🇰🇷 Korea If you are in Korea, it is important to expedite your application for long-term care approval through the National Health Insurance Service. 🇺🇸 U.S. If you are in the United States, it is important to obtain your primary care physician's opinion on homebound certification and the medical necessity of skilled care. In both cases, expert guidance during the document preparation and system exploration process can be tremendously helpful. As a Sierra Care Advisor, we are familiar with systems in both Korea and the United States and will work with your family to find the most suitable in-home care approach.
Sources: National Health Insurance Service "2024 Long-Term Care Insurance Statistical Yearbook" (published June 2025), Ministry of Health and Welfare Long-Term Care Insurance Policy Guidance, National Assembly Budget Office NABO Focus No. 113, KFF (Kaiser Family Foundation) "Medicaid Home Care (HCBS) in 2025," CMS (Centers for Medicare & Medicaid Services) 2025 Medicare Parts A & B Premiums Fact Sheet, Medicare.gov Home Health Services Coverage, AARP Home and Community Preferences Survey, Seniorliving.org "Medicaid and Medicare Statistics in 2026."
Note: This article was compiled by AI from the sources cited above. We strive for accuracy, but for decisions about your specific situation, please confirm the latest guidance from a professional or the relevant agency.