Low Income -- Paying for Home Care
How to Pay for In-Home Care With Public Benefits
If your loved one has very low income and few assets other than the home he or she lives in, the following benefit programs might pay a limited amount for providing in-home care.
Medicaid covers short-term in-home care for acute conditions, usually following a stay in a hospital or rehabilitation or skilled nursing facility. Also, some (but not all) state Medicaid programs cover a limited amount of long-term in-home care for those who qualify.
However, even in those states that provide long-term home care coverage, Medicaid rules often limit it to people whose physical or mental condition is severe enough that it would qualify them for Medicaid nursing home coverage. Also, Medicaid will only pay for in-home care if provided by a Medicaid-certified home care agency, not by an independent paid caregiver or family member (but see Cash and Counseling, below, regarding whether you or other family members might get paid).
To find out about Medicaid eligibility and coverage for in-home care in your state, contact the state's Medicaid agency by going to the online directory for state Medicaid agencies or to your local Area Agency on Aging.
Note: Neither traditional Medicare nor Medicare Advantage plans cover long-term in-home care, but both do cover short-term in-home care for acute conditions, usually following a stay in a hospital or rehabilitation or skilled nursing facility.
The relatively new Program of All-Inclusive Care for the Elderly (PACE) provides comprehensive home and community care for frail elders who would otherwise require nursing home care. PACE is only available in certain areas of some states, and eligibility is restricted to low-income seniors, usually those eligible for both Medicare and Medicaid. To see if there's a PACE program operating where you live, and, if so, how to contact the program, see the Medicare official website list of PACE programs.
Veterans and the surviving spouses of veterans may be eligible for some in-home care assistance from the Department of Veterans Affairs (VA) -- either through health benefits offered to veterans or in the form of a monthly cash benefit. If your loved one is housebound, these benefits may be even higher.
Cash and Counseling (payment to family members)
If your family is like most, it's you and other family members who provide most of your loved one's in-home care. But what if you or other family caregivers have to give up paid work in order to provide that care? The Cash and Counseling program may be able to help.
In some states, Medicaid or another state agency runs a program that pays elders directly to cover at least part of their in-home care. (Note that some states run similar programs under different names.) The amount the program pays depends on the program's assessment of the person's care needs. If your loved one qualifies for the program (the standards, in some states, are slightly easier to meet than for regular Medicaid coverage), he or she can then use the cash benefits to pay you or other family members, or independent home care workers, to provide care.
To find out about a Cash and Counseling or similar program in your state, contact the state Medicaid agency online or contact your local Area Agency on Aging.
Tip: Get free help with Medicaid, Medicare, PACE, or Cash and Counseling programs. If you need help with questions about Medicaid, PACE, or Cash and Counseling coverage of in-home care in your state, you can get free, expert counseling at a local office of the State Health Insurance Assistance Program (SHIP) or Health Insurance Counseling and Advocacy Program (HICAP).