Being a family caregiver for a senior loved one can be a significant challenge without financial assistance. According to AARP, caregivers can end up paying thousands of dollars from personal funds to help the senior.
In fact, the study found that family caregivers spent an average of $7,000 per year of their own money, and if the caregiver lived an hour or more away from the senior, the amount rose to $12,000.
Out-of-pocket costs could include:
Medical needs: Co-payments for physicians, hospitals and prescriptions; equipment such as wheelchairs, oxygen concentrators and hearing aids.
Personal care expenses: Clothing, incontinence supplies, shampoo, soap, and items for pet care.
Education, travel and legal fees: Traveling to provide care, retrofitting vehicles to accommodate wheelchairs, legal consultations, and caregiver training.
Paid help: Costs for assistance and respite care, including adult day care, counseling, geriatric care managers, and hired companions.
The careers of family caregivers can also be affected. Caregivers often have to take time off from their job, reduce their work hours, and miss opportunities for promotions. They may also have reduced amounts of money to set aside for their own retirement.
The result is that most caregivers dip into their personal savings, spend less on their own health care, and take out loans to make ends meet.
Reimbursement and Resources
There are federal, state, and local government programs that can offer financial assistance to caregivers or help seniors meet more of their own expenses. However, there are multiple factors that have to be considered.
- What state does the senior live in?
- What are the family’s assets?
- Is the senior a Veteran?
- How old is the senior?
- How much care does the senior need?
Medicaid
Medicaid offers several programs in different states that can be used to pay a family caregiver:
Long-Term Services and Support (LTSS) provides seniors who need long-term care financial support in order to manage when and how they receive care. In some states, seniors can choose to pay a family member for their care. The details of the program vary by state, and go by different names in various states, such as “Cash and Counseling” or “Personal Choices.”
(Note: Even the name “Medicaid” is different in individual states. For example: Medi-Cal in California, MO HealthNet in Missouri, MassHealth in Massachusetts, etc.)
Adult Foster Care programs are offered in some states that allow the adult children to become foster care providers for their aging parent(s). The aging parent moves into their adult child’s home. The caregiver/child is responsible for providing personal care and assistance with the activities of daily living (bathing, dressing, meal preparation, transportation to medical appointments, and other supports). In return, the adult child is compensated by Medicaid for their care services.
Home and Community Based Service Waivers (HCBS) are available in the majority of states. Again, the terminology for the program varies by state. Under one part of the program, seniors are able to select the personal care assistants of their choosing, including friends and relatives who are compensated for their service.
HCBS Medicaid waivers are not an entitlement program like Medicaid, meaning there are caps on the number of people who may participate, so a waiting list is a possibility.
Medicaid Personal Care Services. Similar to how waivers work, this option allows the senior to designate adult children to provide care. The adult caregiver children are paid the Medicaid-approved hourly rate for their efforts.
Medicaid.gov provides more information on Self-directed Medicaid Services that promotes choice for participants.
Medicare
Medicare does not offer financial assistance to caregivers. However, to assist with the costs of care, some seniors are eligible for a Medicare Savings Program. The assistance includes help from a state in paying Medicare premiums and, in some cases, receive assistance in paying for medical deductibles, coinsurance and copayments.
Supplemental Security Income (SSI)
This a government program administered by Social Security, which provides cash financial assistance for people who have little or no income or resources and are 65 and older, blind, or disabled. Qualified seniors receive a monthly cash benefit. Some states also add an additional amount of money to this benefit.
Veterans Benefits
If a senior is a military Veteran or the surviving spouse of a military Veteran, they may be entitled to several different benefits. Veterans Affairs (VA) offers health care services, pensions and disability compensation to eligible Veterans and their qualifying family members.
Veteran-Directed Home and Community Based Services program is also referred to as Veterans Directed Care. The program is open to any Veteran enrolled in the VA health care system whose care requirements are such that support with activities of daily living are required. The program gives Veterans the option to hire family members to provide them with personal care services. The caregivers are paid an hourly rate as determined annually by the Veterans Health Administration. The program is run at the local level through participating VA Medical Centers.
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