Will Medicare accept property as payment or collateral?

A fellow caregiver asked...

We are in desperate need of having someone come help us during the night. The issue of course, is money. I would like to know if there is any coverage or plan through medicare, where property can be used as collateral for care. For example, Medicare could then use the property for payment when the patient passes away. We are okay during the day but nights are very hard, especially since the patient doesn't sleep through the night. It's sometimes as as often as 4 times a night that we are awakened. Help! What can we do?

Expert Answer

You are in a situation a lot of people find themselves in "trying to help someone stay at home rather than have to enter a nursing facility or other long-term residence, but unable to provide enough round-the-clock care. Unfortunately, Medicare's home care coverage is extremely limited. It's available only to people who need skilled nursing care, and only when "“ and only for as long as -- they are recovering from an illness, injury or treatment. So, if the person you're caring for fits those Medicare home care coverage requirements, you might be able to get some assistance through Medicare. It would come in the form of nursing and other assistance with the patient provided by a Medicare-licensed home health care agency. The agency, in cooperation with the patient's doctor, would set up care plan that addresses the patient's medical needs. But they would NOT provide round-the-clock care in any circumstance, and are unlikely to provide any help during the night. Also, whatever, copayments are required to be made for the care they do provide must be paid directly to the home care agency. Medicare itself would not get involved in the use of property as collateral for payments.

If your situation involves someone who needs care during the night because of long-term frailty, incontinence, dementia, or other problem that does not involve recovery from an acute medical condition, Medicare does not provide any home care coverage at all. On the other hand, you may be able to arrange for private home care assistance at night, through a licensed home care agency or registry, or with an independent home care provider. You would have to pay for that care yourself, unless the patient is eligible for Medicaid home care coverage, which is possible if he or she has very low income and few assets. If you have to pay for the care yourself, you would have to make private arrangements regarding your property, perhaps using it as collateral for a loan.