Compassionate Friends Homecare



VA Benefits, Medicaid, Medicare and Other Payment Options

​ ​It's no fun to lie awake worrying all the time. But if you have elderly parents or other family members living alone,  that's what you do, especially as time goes on and you know they aren't fully able to take care of themselves  anymore. Your first thought may be of a nursing home or assisted living, but many seniors feel strongly about  staying in their homes and aging in place. Compassionate Friends Homecare will offer the assistance needed to  keep you or your loved one living at home. 

 How Much Does In-Home Care Cost?

 Costs depend on whether you're looking for homemaker services -- defined as "hands-off" care, such as cooking, cleaning, running errands, and general companionship -- or home health aide services, which include personal care, such as bathing and dressing.

 A comprehensive 50-state survey of care costs by MetLife found that as of 2011, average hourly rates for home  health aides ranged from $16 to $29 across the country, while rates for homemaker aides without medical training  ranged from $13 to $24. Typically the cost in Ohio ranges from $18 to $25 depending on the needs of each  individual. We have found that the larger companies are charging $24 to $35 an hour and more. They charge "extra" for husband and wife clients, nights, weekends, and mileage. We don't charge any "extras" at Compassionate Friends Homecare.

 But either way, the costs add up, particularly as most people eventually need care and companionship at least a  few days a week, if not full-time. Before you panic, consider that many, many families across the country are  finding a way to do this. And they're not just rich families, but also those who are struggling to make ends meet.

​​Veterans Benefits Can Help You Pay for In-Home Care

If your senior loved one was a veteran, you may be in luck when it comes to financial assistance -- but you'll have to be assertive and persistent to get it. Veterans who served more than 90 days of active duty, with at least one day during a wartime period, with an honorable discharge, may be eligible for the Veterans Pension. Veterans who need long-term help with the activities of daily living -- or whose spouses need such help -- may be entitled to monthly disability payments known as "aid and attendance" by the VA.

This type of veterans benefit requires documentation from a doctor and is calculated using a complex rating system based on how disabled your loved one is. Many people become daunted by the complexity of the qualification process, but once veterans benefits are established they can be extensive and continue until the end of life. According to the Senior Veterans Service Alliance, only 5.4 percent of veterans who are eligible for these benefits actually receive them, because so few veterans know about the benefits and how to qualify. Help is available from Veterans Service Organizations (VSOs). Compassionate Friends Homecare will put you in touch with your local VSO, and they will help you fill out the paperwork for approval. Call today for your local VSO phone number and address. 

How Life Insurance Can Help You Pay for In-Home Care

If your loved one has a life insurance policy that's no longer needed to provide for others, your family may want to tap into that money now, using accelerated or living benefits. The way this works is that your loved one sells the policy back to the issuing agency for 50 to 75 percent of its face value, an amount determined based on the amount of the policy, the monthly premiums, and the policy holder's age and health.

There may be restrictions; some policies can only be cashed in if the policyholder is terminally ill. But many are quite flexible. And if yours isn't, there are settlement companies that will buy the policy -- also at 50 to 75 percent of face value -- then pay the premiums until the policyholder passes away, when the company will collect the benefits.

If the company that issued the policy won't cash it in, don't worry. Your loved one may be able to sell the policy for a "life settlement" or "senior settlement." In this case the settlement company pays the premiums until the policyholder passes away, then receives the benefits that would originally have gone to the policy's original beneficiaries.

How to Use Long-Term Care Insurance to Pay for In-Home Care

This seems like a no-brainer, but unfortunately it's not. Some long-term care insurance policies pay for in-home care, but many cover only nursing home care. And some policies that do cover in-home care require that the home health care agency be certified and that your loved one's health needs be serious enough to require a nurse practitioner or home nursing aide.

If your loved one is lucky and their policy is one of the more flexible ones, then it should designate a certain amount per day for home care to be spent on the type of aide you choose.

One more thing: It may be too late for your aging loved ones to purchase a long-term care insurance policy, but you might want to consider this option for yourself.

How to Use an Annuity to Pay for In-Home Care

Annuities are designed to help seniors turn retirement savings or a pension into a steady, guaranteed income stream that pays out until death or for a set number of years. The money can be used to pay for in-home care or, eventually, for assisted living if necessary. An annuity is like a cross between an investment fund and an insurance policy; the money is invested at a fixed or variable interest rate, and then, after an agreed-upon maturation date, you can begin making withdrawals.

Annuities have become controversial because of unscrupulous representatives who take advantage of vulnerable seniors. So help your loved one find a reputable financial institution and representative to consult regarding an annuity purchase.

Another benefit of an annuity is that the sum invested isn't considered an asset when applying for Medicaid. The government counts the income paid out from the annuity, but not the amount originally invested.

How to Use Medicare to Pay for In-Home Care

It's not easy to get Medicare coverage for in-home care, and when you do it's strictly limited. That said, it can be a godsend when you're faced with a sudden medical crisis or downturn in your loved one's condition. Medicare coverage is most common when your loved one is being discharged from the hospital or a rehabilitation facility. You'll contract through a Medicare-certified agency for a period of skilled nursing care and therapy that's tied to a certain period of expected recovery.

The good news is that Medicare coverage is easier to get than it used to be, and sometime in 2013 it should become easier still. Thanks to the settlement of a lawsuit, Medicare coverage for skilled nursing care and occupational and rehabilitative therapy -- either at home or in a nursing home -- can't be limited by whether or not the patient's condition is improving. Prior to the lawsuit, Medicare criteria would cover treatment only if the patient's condition showed improvement, which meant that people with chronic conditions like COPD, heart failure, Parkinson's, and Alzheimer's lost coverage after a certain period of time.

How to Use Medicaid to Pay for In-Home Care

If your loved one's income is low and he/she has very little in the way of savings or other financial resources, they may qualify for Medicaid-covered in-home care, at least on a limited basis. Medicaid rules vary state by state, but all programs cover short-term in-home care for acute conditions.

Longer-term care for chronic conditions is covered for those who are ill or incapacitated enough that they would otherwise require nursing home care. These programs are known as Home and Community-Based Services (HCBS) "waiver" programs, because they're funded by Medicaid through waivers of normal Medicaid rules. 

Warning: It would be a mistake to try to qualify for Medicaid by hiding money and other assets by "gifting" them to adult children or other family members. The government is extremely strict about Medicaid qualification and will do a "look-back," examining your financial transactions over the past five years. Any gifts of money or assets made during this time are counted as assets, and the penalties if you're caught are very steep.

How a Reverse Mortgage Can Help You Pay for In-Home Care

Reverse mortgages were developed by the government specifically for the purpose of helping seniors (originally widows) stay in their homes until the end of their lives.

With a reverse mortgage, seniors can use the value of the equity in their home to get cash now, either all at once or in monthly payments. But instead of borrowing a set sum, the loan balance increases over time. A reverse mortgage allows your loved one to stay in the home until they pass, even if by that time the loan balance exceeds the home's worth. But at that point, the home must be sold to repay the loan balance.

Reverse mortgages do have limitations: Your loved one has to be 62 or older, and they have to own their home, either outright or with little debt left on the original loan. (The bank that holds the original loan must be paid back before payments are made on the reverse mortgage.) The bank decides on a value based on the home's worth and also based on your loved one's age, since that affects the length of time the payouts must cover.

​While a reverse mortgage may be the perfect solution to your in-home care dilemma, it also comes with strict rules regarding homeowners' insurance, mortgage insurance, and home maintenance, making it easy to default. Choose a reputable mortgage broker or bank and read the entire contract carefully.