Low Income? 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.

SEE ALSO: Find In-Home Care Help Near You

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 benefits

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.

SEE ALSO: Find In-Home Care Help Near You

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).

Joseph L. Matthews

Joseph Matthews is an attorney and the author of numerous books, including Social Security, Medicare, and Government Pensions, Long-Term Care: How to Plan and Pay for It; How to Win Your Personal Injury Claim; and The Lawyer Who Blew up His Desk. See full bio

3 months ago, said...

how can i get nursing home for son totally unable to care for himself--47 yrs. old?

over 1 year ago, said...

Hello! I have a parent who is being discharged from rehab soon after having fallen and broken her femur. She also has been diagnosed with early stage Alzheimer's. I have looked into skilled nursing, which is very much overkill for her needs, and have begun thinking that nursing students (in the geriatric, elder care, Alzheimer's curriculums) may be able to help. The scenario I am considering is hiring student(s) to "parent sit" more as companion care, as opposed to caregiving. Just someone to be there to assure no falls, and help with regular everyday tasks. This would benefit both ourselves and the students, and also allow us to avoid the exorbitant rates of skilled nursing/caregivers when that level of care is not necessarily required. Do you know how I might go about finding potential candidates from your nursing programs who may be interested in making some additional money in their chosen field while going to school?

over 1 year ago, said...

I just had to turn down further help in certain programs from Medicaid because Icould not afford $100.00 dollars a month in which she said I would have to pay based on our income. This is crazy they draw the line at$15000.00 a year, around there for a family of two but they don't take into consideration that I,the wife is also disabled. This is unbelievable.!

over 1 year ago, said...

My grandfather keeps falling and I am looking for some possible home healthcare. I need some more information to give to my grandmother on cost and how to get started..

over 2 years ago, said...

We have private i insurance and medicare. Can this be retroactive? It's been approx. 2 years so far. Thank you. My husband cannot be left alone & I work full time 2nd shift. My son has been taking care of him cost free for approx. 2 years. Please E-mail me on where to begin. Want to avoid Nursing homes.

over 2 years ago, said...

Denise 830, There are PACE programs in Michigan. They are primarily is the southern part of the state. (Detroit, Ann Arbor, Grand Rapids and Lansing areas.) There is also a PACE opening in the Midland, Bay City and Saginaw area in early May 2015. I hope that this helps.

over 2 years ago, said...

Is there a PACE in Michigan?

over 5 years ago, said...

Thank You! there is a wealth of information here that most new caregivers would not know about.

about 6 years ago, said...

The thing to keep in mind with Medicaid is that one's assets and income is that your loved one's assets and income must be very limited indeed for them to qualify.

over 6 years ago, said...

This article was extremely helpful because I am trying to be proactive about what I can possibly expect or what can I do if I needed these type of services.

over 6 years ago, said...

FamilyCare in Wisconsin is for long-term care in the community. You have unlimited options on FamilyCare with a care for sustainability. There is an option for Self Directed Supports where anyone can be hired by the recipient to provide care in the home. Wisconsin finally realized that it is more cost effective to care for Seniors and the disabled at home rather than in a nursing home.

over 6 years ago, said...

To be eligible for PACE in WI, you only need to be Title XIX (Medicaid) eligible. Applicants do not necessarily need to have Medicare. But if you do have Medicare, you must have both parts A&B.