Paying for home care
When you’re youngish, healthy, and independent, it’s hard to imagine ever needing help with anything—until you have a loved one who needs care. Once you start exploring ways to help a parent or grandparent stay safe and comfortable in their home, you may start looking ahead to your own future needs too.
According to recent surveys, over 90 percent of people 65 and older want to stay in their homes for as long as possible, even if they need some help to do so. Fortunately, most family members want the same for their loved ones.
The difficult question: How to pay for it?
There are a number of government programs in place to help low-income families pay for home care. But middle-class families are in a much tougher position. Medicare covers only intermittent care at home under very specific circumstances and does not cover long-term, non-medical home care. While Medicare reform is often talked about, real changes to legislation that would help middle-class families pay for care at home seem a long ways off.
The cost of care
Paying for a professional caregiver can cost anywhere from minimum wage on the low end to more commonly between $20 and $40 an hour, depending on the services provided and where you live. Basic assistance with food preparation and light chores will cost slightly less than personal care like bathing and toileting. You should expect to pay at the higher end of the scale in urban areas and regions where the cost of living is higher (like the east and west coasts).
Your payment options
For most families, these are the best options for paying for in-home care:
Look into insurance
Long-term care insurance – Some people assume that long-term care insurance is primarily for assisted living, but it usually pays for in-home care professionals too. As a result, you can be reimbursed for your payments to home care agencies that meet the requirements of your policy. If you’re planning for your own future, especially if you want to continue to live at home while receiving care, the earlier you start applying for long-term care, the better. Check out these long-term care insurance questions and answers for more information.
Life insurance – If you have a life insurance policy, you may be able to convert it into a long-term care benefit plan, providing cash monthly payouts for in-home care. Check with your insurance provider for details on your plan.
Use your personal assets
Most families wind up using personal savings to meet the needs of caring for an older loved one. Paying out-of-pocket can pose a hardship for many family members if the person needing care doesn’t have enough savings or assets to cover their own needs. Here are some creative ways families manage the challenge:
Divvy up the duties – Call a family meeting with your loved one, their partner or spouse, your siblings, and other close family members to determine what needs to be done and who has the time, ability, or resources to do it. Family members who live farther away may be able to offer more financial help. Those living nearby may be able to assist with driving, shopping, or personal care. When outside help is needed, determine together how you will share the cost. It’s best to come to an agreement early and then adjust as the circumstances change.
Tap into home equity – If your loved one owns her own home, consider a home equity loan to defray the costs of professional in-home care.
Move in with Mom – Is there someone in the family who would be a good roommate and also could benefit from free room and board in exchange for help with dressing, cooking, cleaning, and walking the dog? A college student or single adult might be able to shrink out-of-pocket costs for caregiving by being there during non-work or school hours.
Access public programs
These programs serve people with very low incomes:
Medicaid covers some short-term care if you’ve had a hospital or skilled nursing stay or rehabilitation.
PACE (Program of All-Inclusive Care for the Elderly) provides comprehensive medical and social services to certain frail, community-dwelling elderly individuals, most of whom are also eligible for Medicare and Medicaid benefits.
Veterans Affairs (VA) provides veterans and eligible surviving spouses with some in-home care assistance through VA health benefits. Learn more about home care benefits for Veterans and see if you are eligible.
Cash and Counseling programs pay you or other family members for providing care for a relative. In some states, these programs are run by Medicaid or other state agency. They pay older people directly to cover some of their in-home care costs. Programs vary by state and go by different names. In California, for example, this program called In-Home Support Services (IHSS).
Compare long-term care costs
Want more information? This helpful online tool lets you calculate the current costs of different types of care (daily, monthly, annually) in your state and future costs of care.
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