How to pay for care

by Rachel Hager

Unrecognizable female home healthcare nurse comforts unrecognizable senior female patient who is wheelchair-bound.

Money matters

When it comes to trying to figure out how much it will cost to pay for a loved one's care as they age and become less able to take care of themselves, planning can only go so far.

Nancy Kalikow Maxwell thought she'd done everything right. While her 93-year-old mother was in a memory care facility in Kansas City, Missouri, the family had all the documents, care plans and finances in place.

Maxwell, a librarian, was based in South Florida, but her sister Barbara lived close to their mom. And when Maxwell decided that both financially and emotionally she couldn't continue to split time between Florida and Missouri, she moved to Kansas City too.

But despite all their preparation, the family's financial adviser told them that their mom had six years before she would run out of resources in her current facility. At that point, it would be a situation of, "Well, now what do we do?"

Maxwell and her family are the lucky ones. A large majority of Americans find themselves at, “Well, now what do we do?” from the start.

The good news: More than 400 programs provide financial assistance for eldercare. That help comes from federal, state and local government programs, the VA, nonprofits, private organizations, and additional agencies.

But eligibility qualifications vary and they change frequently. Figuring it out can be a job in itself.

Experts who can help

When money is tight, it can be tempting to try to figure it out yourself. But with so many different programs to sort through with different eligibility qualifications, that can be a job in itself.

You may have heard, for example, that in order for your loved one to be eligible for Medicaid they need to “spend-down” their assets or be subject to a five-year look-back period that analyzes their financial transactions.

But in some states, including New York, this only applies to nursing home placement, not in-home care. Reaching out to someone who knows the ins and outs can help steer you to the programs best suited to your situation.

That could be a:

Social worker
Geriatric care manager
Local community service organization

Key resources

It can be overwhelming to navigate the tricky web of programs designed to help older Americans. Here are some resources to get you started.

Your local Department on Aging can guide you with regard to Medicaid, plus they can direct you to services and programs, like Meals on Wheels or Friendly Visitors, that you may not have known existed. Minnesota’s Medicaid program is called Medical Assistance (MA) and covers nursing home care and some personal care. The state also offers Medicaid Waivers, which help pay for home and community based services for elderly and disabled individuals.
The Older Americans Act entitles anyone 60 and older to free legal and other assistance.
The National Council on Aging (NCOA) offers the latest news, resources and information on the types of services and programs elders may be eligible for. Check out NCOA’s Benefits Finder.
The Administration for Community Living (ACL) offers a wide range of community programs including an online elder care locator or call 800-677-1116.
The Veteran's Association if your loved one served in the military
Charitable organizations such as those run by churches, synagogues, mosques
Your local United Way
Long term care insurance may help depending on the policy

Minnesota-based programs

Minnesota state programs

Some states have non-Medicaid programs that can be accessed through your state’s Department of Human Services. Minnesota, for example offers several:

The Consumer Support Grant program, which provides cash assistance
The Alternative Care program, which helps seniors who need nursing home care remain in their or their caregiver’s home
The Essential Community Supports program provides financial assistance toward remaining to live independently
The Housing Support Program offers financial assistance for foster care or assisted living facilities

What about long term care insurance?

While long term care insurance can seem like the answer, it isn't always so simple. At times, figuring out how to satisfy complex policy requirements can be more hassle and money than the benefits offered are worth.

“I had one case where it took more time at my hourly rate to access the policy than the woman got from it,” said geriatric care manager Irene Zellerman, CSW, CASWCM, of Hearthside Care Coordinators in Brooklyn, NY. To further prove her point, Zellerman recounts that a few years ago a long term care insurance company offered a discount to the association of geriatric care managers. Not one person took it. “What does that tell you?”