Paying for Senior Care: Government Resources and Aid
Last Updated: April 2, 2013
The cost of senior care can stretch family budgets to the
breaking point, but financial help is available. Medicare, Medicaid
and the Department of Veteran Affairs offer assistance programs
that can help pay for eldercare in certain circumstances.
Medicare is national health insurance that all Americans
receive when they turn 65. Disabled people who are under 65 can
also enroll in Medicare without paying premiums. Medicare is
usually not helpful to those looking for a solution to long term
Medicare Covers Only Short-Term
Medicare can cover short-term rehab stays at a nursing home, for
example, after a hospitalization. It can also pay for rehab and
therapy at home for a limited period of time and when prescribed by
But it's vitally important to recognize that Medicare does not
pay for custodial care. Medicare should primarily be considered
health insurance. This means Medicare does not pay for the
following types of senior care:
- Assisted living
- Long term care at a nursing home
- Residential care homes
- Any long term care
For more information about Medicare, see http://www.medicare.gov.
Medicaid is the foremost government assistance program paying
for long term care for people who can't afford it on their own. It
is administered cooperatively by the federal government and states.
While the majority of its funding comes from the federal
government, each state has some discretion in its individual rules,
regulations and eligibility requirements.
Eligibility for Medicaid
- A senior has to put almost all of his or her existing assets
- Low income, or at least have medical or care expenses that are
higher than income.
- If a married couple wants to qualify for Medicaid, the couple
does not need to have exhausted all financial resources. The
healthy spouse can usually keep the home he or she lives in, but
may still have to make significant sacrifices.
Medicaid is the Social Safety Net for Ailing Elders
Medicaid is the safety net for Americans who need care that they
cannot afford privately. Like Medicare, Medicaid acts as health
insurance. But unlike Medicare, Medicaid can be used to pay for
long term nursing home care in all states. Many states also allow
their residents to use Medicaid to pay for assisted living
communities or other alternatives to nursing homes such as in-home
Some states even offer a program through Medicaid called PACE
(Program of All Inclusive Care for the Elderly), which covers all
of the senior's care and medical needs through one contracting
agency, with the goal of allowing people who have traditionally
gone to nursing homes to stay in the community (at home) with
State Medicare and Medicaid Guidelines
Each state has its own guidelines, so you will need to contact a
State Medical Assistance office for more details:
You may also want to speak with an elder planner or elder
attorney who can help guide you through the nuances of a successful
Veterans who are at least 65 years-old and who served during war
time (though not necessarily in actual combat) may be eligible for
financial assistance through the Department of Veteran Affairs (VA)
that can be used to help pay for care. Spouses, surviving spouses,
and even other dependents of the veteran may be eligible for
assistance in some cases as well.
There are three levels of VA benefits for wartime veterans and
their dependents, which are based on the needs of the
- Basic Pension:Basic Pension is designed to function as cash
assistance for low income veterans and their dependents. Applicants
may be healthy.
- Housebound Benefit:Housebound assistance with day-to-day
activities must be needed on a regular basis.
- Aid and Attendance:Assistance must be required on a "daily
Assistance from the VA is "means tested," in other words, only
people who are deemed genuinely in need will receive an award. It
also means that the amount of the benefit is based on the
applicant's income, assets, and needs. Applicants whose countable
incomes are over maximum thresholds, or who have more than $80,000
in assets (excluding the home they live in and the care they
drive), will usually be denied. But in situations that are
borderline, it can't hurt to apply, as decisions are largely made
on a case by case basis.
How to Apply
Like Medicaid, VA benefits can be extraordinarily complex. For
this reason you might also consider speaking with a Veteran
Services Officer. Veteran Services Officers volunteer through the
United States, frequently at hubs for veterans like American Legion
halls Veteran of Foreign Wars (VFW) lodges.
To apply for VA health care or determine eligibility,
- Call (877) 222-VETS: Health Benefits Service Center
- Contact your local Veterans Benefits Office or Medical
- Visit the Department of Veterans Affairs website www1.va.gov/directory/guide/home.asp
Non-Government Options for Financing Senior Care
Medicaid, veteran aid, and to some extent, Medicare, are the
government originating programs that help pay for care for older
people in the United States. But there are alternatives. Some
families also explore little known tools such as
reverse mortgages and
life settlements to raise funds to pay for necessary care.
Our Senior Living Advisors are happy to discuss, at no
cost, the financial aspect of care planning. They can talk you
through the options, and even suggest local experts who can help if
you wish to pursue any of the financial aid options outlined in
this article. Talk to a
Senior Living Advisor in your area today!
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