Many older adults prefer to age in their homes, and studies have shown the mental and physical benefits of doing so. Yet, as we age and need more help with daily tasks, supporting yourself or an older loved one living alone can be hard. 

In-home care is a good solution if you want to continue living at home but need some help with your daily personal care, things around the house, errands and more homemaking responsibilities.  

But, in-home care can get expensive. According to Genworth’s Cost of Care Survey, in-home costs an average of $28 per hour. Most people need several hours of care per week, so costs can add up quickly. 

You can use the below suggestions to help ease the burden of paying for in-home care. 

Use Medicaid Benefits

Medicaid generally does cover at least some home care services, including non-medical care like homemaker services. Typically, Medicaid will only cover services provided by certified agencies, meaning private or family caregivers cannot be paid via standard Medicaid. Coverage and limitations can vary from state to state, but in many cases beneficiaries need a doctor to state that the in-home care is medically necessary. 

Learn more about state Medicaid programs on Medicaid’s website or by contacting your local Area Agency on Aging

Look Into Medicaid Waivers

Home and Community-Based Services (HCBS) waivers are supplemental Medicaid programs that expand Medicaid coverage. The goal is to give beneficiaries more options on where and how they can receive the care they need. 

HCBS waivers can cover:

  • Personal care services to help with ADLs
  • Homemaker services
  • Meal delivery
  • Adult day services participation
  • Transportation assistance
  • Assistive device or medical equipment assistance
  • Minor home modifications

There are additional eligibility requirements, usually financial and/or medical, for HCBS waivers that go beyond eligibility for standard Medicaid. Because waivers are unique to each state, so are eligibility standards. Additionally, waivers are often limited in their scope and may have waitlists. You can learn more on the Medicaid website

Get Family Members Paid for Their Care

Another way to use Medicaid to pay for in-home care is through the self-directed services program. With this program, eligible Medicaid beneficiaries can choose to “employ” a family member or other loved one for personal care services at home, and Medicaid will pay the caregiver. Note that the program specifics and eligibility vary for each state, so not everyone is eligible. However, it’s worth checking the options in your state if you’re planning on using a family caregiver for in-home care.  

Get a Reverse Mortgage

Reverse mortgages allow homeowners to turn some of their home equity into cash which they can use for expense including in-home care. These mortgages are not a solution for everyone as they are only available to people 62 years of age or older who own a home and have paid off their original mortgage (or have gotten close). The loan must be paid back when the homeowner passes away or moves. 

Reverse mortgages do have downsides. They can sometimes carry high fees, and it puts you at risk of foreclosure. It can also make things complicated if you want your spouse to remain in the home if you pass or move to senior living, or were hoping to pass the house down to future generations. Talk to a financial advisor before getting a reverse mortgage to ensure it’s the correct type of loan for your situation. 

Use Funds From An Annuity

If you’ve been paying into an annuity, these funds can be a great way to pay for in-home care. However, if you’re a senior and you don’t already have one of these accounts, be wary. Older adults are often targeted for annuity scams which can result in financial losses. 

Check Your Long-term Care Insurance Policy

If you have a long-term care (LTC) insurance policy, it may cover some costs of in-home care. Some LTC policies only pay home care benefits to a licensed home care agency or other licensed provider. Others pay a set daily amount to the insured person who qualifies for the benefits. This means you can spend that money on any caregiver you choose, including family members.

Convert A Life Insurance Policy To Cash

Some life insurance policies can be cashed in with the insurance company, usually for 50 to 75 percent of the policy’s face value, though some policies permit these “accelerated benefits” or “living benefits” only if the policyholder is terminally ill.

If these accelerated insurance benefits aren’t available, you can investigate whether a “life settlement” (also called a “senior settlement”) may be possible. This involves selling the policy to a life settlement company (different from the insurance company that issued the policy) for a lump sum.

Both options have downsides like reducing your payout amount and possibly being taxable, so carefully consider the pros and cons and speak with a financial expert before cashing out a life insurance policy. 

Make Sure You’re Taking Advantage of Veterans Benefits

If you or your loved one was a veteran and was discharged honorably, you may be eligible for cash-payment VA programs that you can use towards paying for in-home care. The Aid & Attendance benefit and Housebound allowance are monthly payments added on top of your VA pension, designed to help senior veterans and surviving family members pay for care, including in-home assistance. 

To get one of these benefits, you must meet medical eligibility requirements, such as being housebound due to a disability, having poor eyesight, or needing help with activities of daily living. 

Visit the VA website to learn how to apply for these programs. 

Next Steps

In addition to the stress of paying for in-home care, if you’re planning on using a non-family caregiver, you also face the challenge of finding someone reputable, reliable and insured to entrust with your or your loved one’s well-being. For free assistance finding trusted, quality in-home caregivers, contact a Caring.com family advisor at (800) 973-1540. 

In addition to those already mentioned, make sure that you or your loved one take advantage of the below programs that can make paying for care easier.

Resource

Contact

Brief Description 

Apply online or contact your local SSA office. 

This provides monthly cash payments to very low-income seniors with limited assets.

Contact your local SSA office with application questions. 

Offered by most states, OSS/SSP programs are intended to supplement federal SSI payments via cash payments to those already receiving SSI benefits or who would qualify for SSI benefits if not for their income.

Apply online or contact your local SSA office.

Those with a medical condition that will last at least a year or result in death and who worked a qualifying amount of time , may be eligible for SSDI payments.