The Caring Corner®
FAQ: How do I pay for home care? Does Medicare pay for it?
Answered by Mary Nielson, Executive Director, LovingCare@Home, Sun City West, AZ 85375
Sadly, Medicare does not pay for in-home non-medical care much as it doesn’t pay for long-term nursing home care. Staying at home is a much better option and costs about the same as a private nursing home for live-in care. There is some hope that under “Obamacare” Medicare may realize home care is a practical and often lower-cost alternative in both the short and long term. Payment options include:
Long Term Care Insurance (LTC) – Some far-sighted folks bought LTC. Some of those purchased the home care option. In this case, LTC will pay for in-home care usually through a licensed agency. In Arizona, there is no license required for home care, so sometimes there is a little difficulty in getting payment. Usually we can fix that when we talk to your insurance company.
Savings and Investments – Many of us are woefully short in this area, but those who weathered the Depression are more likely to have a nest egg.
Family – Many times children will pool resources to give Mom or Dad the care they need to stay independent. Or to get home care while they live with one of the kids who continues to work. Two of our clients live with unmarried adult children and use home care while they are at work.
Reverse Mortgage – If there is equity in the home, you can tap it to pay long-term care. Getting a reverse mortgage gives you monthly payments or a lump sum to pay for your needs without any mortgage payments.
Medicaid – In Arizona it’s called ALTCS – Arizona Long Term Care System. Medicaid varies by the state and is reserved for the “poor”. Income and asset requirements have to be met. If you think you will run out of resources before you need them or want to keep them for your heirs, consider talking with an estate planning attorney long before the need to develop a pay-down strategy. Just giving your money away won’t work due to the “look-back period” used for qualifying. In Arizona, many Medicare advantage health plans have a Medicaid option that includes long-term care.
Veteran’s Aid and Assistance (VA&A) – VA&A provides some long-term care help for low-income veterans, their living spouses and surviving spouses. It is not enough to cover full-time care but is a supplement to what the family and other resources pay. There are income and asset requirements and the veteran must have served one day in war-time (not necessarily in the war). You can contact a third-party like Veteran’s Care Coordination or AVCC Home Care to determine eligibility or the Veteran’s Benefits Coordinator at your local VA hospital or office. You may also ask your estate planning attorney to help you qualify or plan ahead to qualify. The service to help you qualify is free – the VA won’t let them charge you for this service.
