Americare Home Care Services, Inc. (“Americare”) has been operating since 1997. It sells pre-paid contracts to consumers for a specified number of hours of nonmedical, in home personal care.
The company is located in Bloomsburg, Pennsylvania. It currently sells in Pennsylvania, Florida, New York, Ohio and South Carolina. It operates through agents who are independent contractors. The agents sell directly to consumers. In Pennsylvania, a large amount of sales are to American Legion members and their families, through an agreement that is discussed later.
Americare was founded by insurance agents who had extensive experience in the long-term care field. They saw the industry changing in the 1990's. Long-term care policies became financially out of reach for many. Carriers were reducing benefits to existing policyholders and making it more difficult to be approved for benefits. The founders saw an opportunity to provide the aging population with a product which would fill a critical need at an affordable price: non-medical home care, sold on a pre-need basis, which would allow individuals to remain in their homes longer and with less stressand burden on their families and finances.
The Americare product is a pre-paid contract in which a consumer purchases a designated number of hours of in home personal care at a price significantly below market rates for the services. The hours must be used within 365 days from the date of the contract; they do not “carry over” or extend beyond the contract term. The contract term is for the earlier of 365 days, or when all hours of services have been used. At the end of the 365 day term, the consumer is offered a new contract. The services available are listed in the contract.
There is no underwriting involved. All consumers are sold the contract at a standard price regardless of age or medical condition. The price-per-hour is determined by the number of hours purchased, but is the same for everybody who buys the same number of hours in a contract. There is no waiting period before a consumer is eligible for services.
Services are provided upon request by the consumer. There is no determination of medical or other need. Services are only provided in the home. That may include a “vacation home” or a location where a consumer is living at the time services are requested; however, it does not include a hospital, nursing home, rehabilitation or other residential facility. The company reserves the right to withhold services if a doctor determines that providing them would be harmful to the consumer, or if doing so would be harmful to the provider.
Americare employs no providers. Instead, it has standing contracts with licensed providers in each state in which is operates. When services are requested, Americare schedules the provider in accordance with the care requested, type of services required and appropriate number of hours. Americare pays the provider directly. Consumers do not contract with or secure providers on their own, as Americare does not reimburse a consumer who has done so, and it does not “pay claims.” Generally, services are provided within no more than 48 hours from the time the consumer contacts the company.
Americare has intentionally kept expansion at a low rate to ensure that it can operate effectively and deliver all services without compromise.
Please note that Americare also uses the registered fictitious name “Evolutionary Concepts” in conjunction with the home services contract. That resulted from an agreement with an unrelated insurance company, which operates under a name similarto Americare’s, over trademark issues.