Private Duty Nurse

A private duty nurse is a licensed nurse hired to provide one-on-one medical care to a patient in their home or hospital outside of standard public healthcare services. This specialized care is typically required for individuals recovering from surgery, managing chronic illness, or living with a serious medical condition that requires close monitoring or skilled nursing services. The nurse may perform duties such as administering medication, wound care, post-operative support, or palliative care under a physician’s supervision.

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In extended health care insurance, private duty nursing is often an eligible expense, subject to medical necessity and pre-authorization by the insurer. Coverage usually applies only to care provided by a registered nurse (RN) or licensed practical nurse (LPN) who is not a relative of the patient. Plans may include daily or annual maximums and require documentation from a physician stating that nursing care is essential for recovery or ongoing treatment.

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Example:

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If your doctor recommends 10 hours of private nursing care each day after surgery and your plan covers up to $10,000 per year for private duty nursing, the insurer will reimburse the eligible portion of your nursing expenses once documentation and receipts are submitted.

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What to Watch For:

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Confirm that the nurse is licensed and that the care is medically necessary according to your insurer’s definition. Obtain pre-approval before beginning care to ensure expenses are eligible. Coverage typically excludes services provided by family members or unlicensed caregivers. Keep detailed invoices showing dates, hours, and professional credentials of the nurse.