8 Home Care Financial Assistance Programs in the US

Updated

Certified Care Manager, Aging Life Care Professional, and National Master Guardian Emeritus

Family caregivers provide most of the care to their loved ones in the US. As those burdens increase, families look to other financial assistance programs to help them take care of someone. It can feel like you’re a detective trying to piece together a plan that keeps you and your loved one’s estate intact. Luckily, there are a few home care financial assistance programs in the US that can help. 

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In-home care is a resource many families turn to for support when caring for a loved one, but the cost can get high, with hourly rates ranging between $20-$40 an hour. There are several ways to get home care, either through an agency or one of the online options that connect caregivers directly with the consumer. However, over time, the cost can start to spiral out of control. You may look to other financial assistance to help pay for home care.

In contrast to home care, home health care is an insurance-covered time-limited service for people who need skilled nursing and physical or occupational therapy. Aides through home health can only provide hands-on assistance with bathing, dressing, and transferring. They can’t help with shopping, cleaning, cooking, transportation, or companionship, all tasks that many people continue to need help with. 

A few home care financial assistance programs can help bridge the gap. Let’s explore 8 home care financial assistance programs in the US that might be the right fit for you. 

Who Usually Qualifies for Financial Assistance for Home Care?

Who qualifies for financial assistance for home care depends on the program you apply to and qualify for. Some programs have strict income and asset criteria along with specific care needs that meet a nursing home level of care. 

In most cases, if you can easily afford to pay for the in-home care, you won’t qualify for financial assistance. The challenge is for families who don’t meet the low income and asset threshold and don’t have the funds to cover in-home care comfortably. In general, once you meet the financial requirements, there are functional needs to consider when applying:

  • Assistance with activities of daily living such as dressing, bathing, and hygiene
  • Assistance with ambulation such as walking or transferring from the bed to a standing position or a wheelchair or walker
  • Assistance with medication organization and management
  • Assistance with toileting
  • Assistance with housekeeping and home maintenance
  • Assistance with getting durable medical equipment and adding home accessibility features
  • Assistance with catheter care and injections
  • Cognitive and mental health problems can contribute to challenges in managing day-to-day functional and other activities

Most financial assistance programs are funded in whole or part by Medicaid. Each state has an asset and income limit depending on family size. In general, you can have no more than $2000 in assets and about $841 a month for a single person. The Medicaid amount will vary a bit depending on where you live, if you are married, and how many people are in your household.

Popular Financial Assistance Programs for In-Home Care

Each state has a variety of caregiver assistance programs. The most popular ones are more accessible to larger groups of people across the US, but some communities will not have these programs. Every state decides how to allocate limited funds to people in need. Now, let’s go through each program to help you choose and apply for the best fit.

1. Medicaid programs

Medicaid is a federal insurance program for low-income persons. The program is administered by the states and pays for non-medical home care, home health care, and other in-home support. Medicaid is the primary payor source for nursing home care. 

In an effort to replace nursing home care with in-home care (saving money for the state and the federal government), various programs support that effort. Keeping people out of nursing homes when possible benefits everyone. 

There are three basic Medicaid plans to pay for in-home care. One is the regular state Medicaid program. The other is Medicaid Waiver programs, and the third is Home and Community-Based Services (HCBS). Traditional state Medicaid programs entitle people to all of Medicaid's health and related services, including home health care and in-home care.

Many Medicaid Waiver Programs allow for consumer direction or self-directed care. These waivers allow care recipients to choose the person they want to receive services from, including relatives. Under Medicaid Waiver programs, there could be long waiting lists for program spots since these programs are not considered entitlement programs. The best way to understand your Medicaid options is to talk to your local representatives since there are different state-specific requirements. 

2. Program of All-Inclusive Care for the Elderly (PACE)

Second, the PACE program is for older adults who have Medicaid and also have Medicare. To qualify for the PACE program, you have to meet a nursing home level of care. If you don’t have Medicaid, you will pay a monthly premium for the services, but if you do have Medicaid, those premiums are waived. 

Unfortunately, the PACE program is limited to a few communities throughout the country, so there may not be one in your location.

Services include but are not limited to: home care, hospital care, occupational and physical therapy, prescription drugs, primary care, social services, adult daycare, recreational therapy, meals, laboratory, and x-ray services. A team develops a plan of care for the individual, which can entail: 

  • Nutritional Counseling
  • Transportation
  • Nursing care
  • Aides
  • A primary care physician
  • Social worker
  • Physical therapist

3. Non-medicaid programs

Next, non-Medicaid programs cover a range of support services for people who don’t qualify for Medicaid. The programs in each state could be very different. For example, in California, a Paid Family Leave option pays someone 70% of their wage to care for a loved one in times of need. 

Another example is the Alternatives program in Utah, which provides in-home services to eligible Utah residents to prevent the premature placement of individuals in nursing homes. This state-funded assistance program prevents individuals from spending-down their resources and enrolling in Medicaid, but there are strict criteria and long waiting lists. Again, the funding for the program is separate from the state Medicaid budget.  

4. Veteran’s programs

Additionally, if you’re seeking help for a veteran, there are many specific programs just for them. Several Veteran’s programs assist Veterans and their families with in-home care. One is Aid and Attendance, which is a cash benefit for eligible Veterans who meet income and asset levels. With the cash benefit, the Veteran can hire in-home help with these funds.

The other program is Veteran Directed Care which allows Veterans to direct their own care with a budget administered and managed by the VA. The recipient can hire caregivers of their choice to provide their care. Both Aid and Attendance and Veteran Direct Care put individuals and families in charge of their care.

A short-term solution for veterans is the VA Respite program. This gives caregivers a break by providing fill-in caregivers for the Veteran. However, keep in mind the respite program is short-term and not a long-range solution for in-home care. 

Lastly, the VA Foster Care program (sometimes referred to as Medical Foster Homes) are private residences where the caregiver provides care and supervision 24 hours a day, seven days a week. This caregiver helps the Veteran carry out activities of daily living, such as bathing and getting dressed. There can be more than one Veteran in a household, and the home-based primary care program provides all primary care duties.

5. Medicare Advantage plans

Traditional Medicare does not cover home care except under the short-term home health program. It also requires a doctor’s order with a skilled nursing need. Aides are available under home health, but only for defined assistance with activities of daily living 2-3 days a week.

However, for those who have Medicare Advantage plans (Medicare Part C), there might be other options. Some Medicare Advantage plans offer services that aren’t provided under traditional Medicare. Some of these services include:

  • Transportation 
  • Installation of grab bars in the bathroom 
  • Air conditioners or carpet cleaning for people with asthma
  • Home-delivered meals
  • Home health aides to help with daily activities like dressing or eating
  • Caregiver support services

Call your Medicare Advantage plan to find out what services are available to you and how to qualify. This is one of the reasons Medicare Advantage plans are becoming more popular since they have more flexibility and support. 

6. Self-payment options

With that in mind, there are other avenues to consider for families that don’t qualify for publicly funded financial assistance programs. If you have a home, you can take out a second mortgage or apply for a home equity line of credit to pay for home care. 

Similarly, you can also dip into savings and retirement accounts to pay for home care. Before you choose this route, make sure you take a close look at your budget. Affording end-of-life and retirement costs is no small feat. The last thing you want to do is risk your financial well-being in the future for short-term relief. 

7. Long-term care and hybrid insurance policies

If you have an existing long-term care or hybrid insurance plan, this can provide the funding you need to afford home care. This is specifically what these insurance plans are designed for, so this is one of the many reasons to consider them yourself. 

The longer you wait to purchase a long-term care insurance policy, the higher your premiums. If you already have a long-term care policy, read the policy carefully since many will have a 90-day waiting period before the company will pay out your daily cash amount. 

There are also some newer options like life insurance policies with a long-term care benefit. Unlike traditional long-term care policies, these policies will pay a death benefit once the policyholder dies. 

8. Inheritance agreement

If you and your siblings have exhausted all financial means to pay for home care, you could divide the cost of home care and agree to be reimbursed at the settlement of the estate. This could be more financially risky, but it might be the right fit depending on your situation. 

Before you choose this route. draw up a document with an elder law attorney that outlines this agreement. Meet with an estate planning attorney to discuss the viability of this idea. It’s always important to have an expert opinion when handling long-term financial plans. 

Home Care Financial Assistance Programs in the US

Home care can be the foundation of support to ease your caregiving burden and reduce stress. Finding financial assistance programs to help you and your loved one pay for home care might be challenging. 

In times like these, don’t be afraid to take a creative financial approach. It might just help you care for your loved one for the long term. Remember, the best solution is to plan before you need long-term care. With that in mind, create your own plan today

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