Are you or your loved one facing long-term care and not sure how to pay for everything? Frequently people utilize a variety of payment sources for their home health or hospice services, including personal funds, government programs, and private financing options. While using personal funds such as savings, a pension or retirement fund, income from stocks and bonds, or proceeds from the sale of a home may be an option for some, not everyone has access to this or it may not be enough to cover everything. There are several federal and state programs that can help with healthcare related costs.
Medicare is a Federal Government insurance program that pays partial medical costs for those age 65+, and for all people with late-stage kidney failure. It also pays some medical costs for people who have received Social Security Disability Income for 24 months.
Medicare Part A:
Hospital costs after your deductible is met
Short stays in a nursing home for some illnesses
Hospice care in the last 6 months of life
Medicare Part B:
Part of the costs for doctor's services, outpatient care, and other medical services that Part A does not cover
Some preventive services, such as flu shots and diabetes screening
Medicare Part D:
You can find more information about Medicare benefits at www.medicare.gov, or call 1-800-633-4227, TTY: 1-877-486-2048.
Some people may qualify for Medicaid, a combined Federal and State program for low-income people and families. This program covers the costs of medical care and some types of long-term care for people who have limited income and meet other eligibility requirements. Who is eligible and what services are covered vary from State to State.
To learn more about Medicaid, call 1-877-267-2323, TTY: 1-866-226-1819, or visit www.medicaid.gov. Or, contact your State health department.
Program of All-Inclusive Care for the Elderly (PACE)
Some States have PACE, which is a Medicare program that provides care and services to people who otherwise would need care in a nursing home. PACE covers medical, social service, and long-term care costs for frail people. It may pay for some or all of the long-term care needs of a person with Alzheimer’s disease. PACE permits most people who qualify to continue living at home instead of moving to a long-term care facility. PACE is available only in certain areas.
To find out more about PACE, call 1-877-267-2323, or visit www.pace4you.org or https://www.medicare.gov/your-medicare-costs/get-help-paying-costs/pace.
State Health Insurance Assistance Program
SHIP, the State Health Insurance Assistance Program is a national program offered in each State that provides counseling and assistance to people and their families on Medicare, Medicaid, and Medicare supplemental insurance (Medigap) matters.
To contact a SHIP counselor in your State, visit www.shiptacenter.org.
Department of Veterans Affairs
The U.S. Department of Veterans Affairs (VA) may provide long-term care or at-home care for some veterans. If your family member or relative is eligible for veterans’ benefits, check with the VA or get in touch with the VA medical center nearest you. There could be a waiting list for VA nursing homes.
To learn more about VA healthcare benefits, call 1-877-222-8387, or visit www.va.gov/health or www.caregiver.va.gov.
Social Security Disability Income
This type of Social Security is for people younger than age 65 who are disabled according to the Social Security Administration's definition.
For a person to qualify for Social Security Disability Income, he or she must be able to show that:
The person is unable to work
The condition will last at least a year
The condition is expected to result in death
Social Security has "compassionate allowances" to help people with Alzheimer’s disease, other dementias, and certain other serious medical conditions get disability benefits more quickly.
To find out more about Social Security Disability Income, call 1-800-772-1213, TTY: 1-800-325-0778, or visit www.ssa.gov.
National Council on Aging
The National Council on Aging, a private group, has a free service called BenefitsCheckUp®. This service can help you find Federal and State benefit programs that may help your family. After providing some general information about the person who needs care, you can see a list of possible benefit programs to explore. These programs can help pay for prescription drugs, heating bills, housing, meal programs, and legal services. You don’t have to give a name, address, or Social Security number to use this service.
To learn more about BenefitsCheckUp®, call 1-571-527-3900, or visit www.benefitscheckup.org.
For more information about Federal, State, and local government benefits, go to www.benefits.gov or call 1-800-FED-INFO (1-800-333-4636).