Paying for in-home care: where families look for help

Costs surprise many families. This is an overview of places to look, not a promise of coverage. Rules change and differ by state, so confirm with the program itself.

Medicare

Medicare can cover some home health services when a doctor orders them and certain conditions are met. It generally does not pay for ongoing non-medical help such as housekeeping, companionship or long-term personal care. Check Medicare's own page for what applies.

Long-term care insurance

If the senior has a policy, ask the insurer what triggers benefits, what the waiting period is and which providers it accepts. Get answers in writing.

Medicaid and state programs

Some states offer home and community-based services through Medicaid for people who meet income, asset and care-need rules. Your state Medicaid office or Area Agency on Aging can explain what exists locally.

Veterans benefits

Veterans and some surviving spouses may qualify for programs that help pay for care at home. The U.S. Department of Veterans Affairs lists its programs, and an accredited representative can help with applications.

Local help

Area Agencies on Aging can connect families to meal delivery, transportation, adult day programs and caregiver support, some of which are low cost or free. The Eldercare Locator finds the agency for any address.

Paying privately

If paying yourself, ask for an hourly rate in writing and plan for how many hours you will need each week. Compare that with other options, such as adult day programs or help from family at set times.

Plan for change

Needs and costs often rise over time. A conversation with an elder law attorney or a financial professional can help families plan, especially before applying for benefits.