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A A A(/)

About Us (/about-us.html)

Contact Us (/contact-us.html)

Glossary

(/longtermcare/glossary.html)

Sitemap (/sitemap.html)

Home (/)

Costs of Senior Care

(/longtermcare/costs.html)

Types of Senior Care

(/longtermcare/types.html)

Paying for Senior Care

All Options(/longtermcare/resources

Ass is ted Li ving

(/longtermcare/paying-

for-assisted-living.html)

Home Care

(/longtermcare/paying-

for-home-care.html)

Home Care Supplies

(/home-care-

supplies/financial-

assistance.html)

Home Modifications

(/home-

modifications/how-to-

pay-for-home-

mods.html)

=121:paying-for-home-care-financial-options-aid-and-yout=default&page=)

pe5_vertex&link=bd93926242b06fda8339e6eecfd6c9bf79147a4c)

Home Care Financial Assistance andPayment Options

Page Reviewed / Updated - May 2015

Find Affordable Home Care (/home-care-

assisted-living/find-affordable-elder-

care.html)Financial Assistance for Home Care

(/longtermcare/resources/locator_tool.html)

Learn about Virtual Home Care (/financial-

assistance/companion-care.html)

Home Care vs Assisted Living Calc.(/longtermcare/home-care-vs-assisted-

living.html)

Table of Contents

Home Care vs. Home Health Care

Costs: Home, Home Health & Alzheimer's Care

Financial Assistance for Home Care Medicare's Benefits Medicaid Help for Veterans

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Nursing Homes

(/longtermcare/paying-

for-nursing-

homes.html)

Medical Equipment

(/durable-medical-

equipment/how-to-pay-

home.html)

Prescriptions

(/prescription-

drugs/assistance-for-

the-elderly.html)

Adult Day Care

(/longtermcare/find_adult

Options By State

(/financial-assistance/50-

states.html)

Resource Locator

Tool

(/longtermcare/resources/locator_tool.html)

Compare Benefits &

Care

(/longtermcare/compare_benefits.html)

Help Planning for

Care

Find Affordable Senior

Care (/home-care-

assisted-living/find-

affordable-elder-

care.html)

Lower Your Cost of

Care

Cost Saving

Technologies

(/longtermcare/aging-

in-place-

technology.html)

FAQs and Helpful

Guides (/eldercare-

State Non-Medicaid Programs Other Options

Self-Payment Options for Home Care Reverse Mortgages / HELOCs / Equity Key

Life Ins urance Policy Conversions Home Care Loans Long Term Care Insurance

Finding Affordable Home Care

Developing a Financial Plan for Home Care

State-by-State Home Care Costs

Home Care vs. Home Health Care

Prior to a discussion of home care payment options, it is

helpful to differentiate between home care and home health

care. Home Care Aides provide custodial care; they help

seniors with their activities of daily living such as bathing,

dressing, housekeeping and transportation. This is also

referred to as personal care, attendant care, non-medical

care and companion care.

Home Health Aides offer skilled care such as checking

patients’ pulses, temperature or respiration. They assist withmedications, braces, ventilators and other medical equipment

and can provide higher level skilled nursing as well as more

basic personal care. Home health aides are also referred to

as nurse aides, nursing assistants, certified nursing assistants

and geriatric aides.

Costs: Home, Home Health & Alzheimer'sCare

Both home care aides and home health aides bill on an hourly

basis (with the exception of live in caregivers

(/longtermcare/live-in-caregiver.html) who sometime bill flat

rates). Home care aides can be retained through a home

care agency or by hiring private caregivers. Home health

aides experience greater federal regulation and are almost

always hired through an agency.

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faqs-and-helpful-

guides.html)

(/longtermcare/resources/locator_tool.html)

Our goal is to help familiesfind the means to pay for seni or care by providingobjective i nformation andinteractive tools on our ad-

free, easy-to-use an dcomprehensive website. Read More (/about-us.html)

Hourly rates for home care vary by asmuch as 50% even in the same state or

town.

Nationwide in 2015, the average cost for non-medical home

care is $20 per hour with the state averages ranging from $15

- $26 per hour. It should be noted that these are average

costs from home care agencies. Private individuals can be

retained to provide most of the same services with fees that

are 20% - 30% lower. However, these independents are

typically uninsured, do not go through background checks

and may be unable to provide alternatives in case they are

not available to work on short notice.

Independent caregivers typically charge20% - 30% less than home care

agencies.

Home health aides visit the home as much as medically

necessary; typically for shorter periods of time than home

care aides. In 2015, nationwide, the average hourly fee isalso $20, the same as for non-medical home care. However,

when looking at different state averages there is $16 - $27.

Alzheimer's care at home can be affordable and relatively low

cost when compared to residential care. Typically home care

providers do not charge additional fees to care for individuals

with Alzheimer's. This is not the case in senior living

residences where Alzheimer's and dementia care usually

costs an additional $1,150 per month.

Financial Assistance for Home Care

Medicare's Benefits

Medicare does not pay for home care

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aides and only selectively covers home healthcare.

Home care aides provide personal care rather than medical

care and therefore Medicare does not cover the cost of home

care. Medicare Supplemental Insurances cover Medicare co-

payments and deductible but do not add new areas of

coverage, therefore these policies are of no assistance for

non-medical home care.

Home health care costs, on the other hand, are considered

medically necessary and therefore they are covered, at least

in part, by Medicare and other health insurance programs.

However, Medicare severely restricts coverage to only those

individuals who are not able to leave their homes and

Medicare will not pay for personal care during the visits, so

the visits tend to be very brief and procedural in nature.Furthermore, the Centers for Medicare & Medicaid Services

have announced annual 3.5% reduction in home health care

provider reimbursements annually until 2017, which will further

impact seniors.

The exception to the limited home care rule are Medicare

PACE programs

(/longtermcare/resources/pace_medicare.html), however

these are available only in limited geographic areas.

Medicaid

Medicaid, an insurance program for low income seniors, does

pay for home health, non-medical home care and other in-

home supports to help the elderly remain living in their

homes. However, Medicaid rules are state-specific andMedicaid covers these services mostly through Home and

Community Based Services (HCBS) Waivers. HCBS Waivers

are different in every state, they offer different benefits,

having varying eligibility requirements and unfortunately are

not entitlements. Medicaid HCBS Waivers have enrollment

caps and waiting lists may exists. Click here (/medicaid-

waivers/home-care.html) for a state by state guide to which

HCBS Waivers cover home care, their eligibility requirements

and application processes.

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Some home care is also offered through Medicaid Personal or

Attendant Care programs. Again these programs are state

specific and can be found at the link above.

Help for Veterans

There are several forms of assistance from the Department of

Veterans Affairs that help veterans afford home care. This

may be direct financial assistance or care services that can

reduce a veteran's overall need.

To start, there are three different pension benefits which can

be applied towards home care. Individuals who require more

care are eligible for higher benefit amounts. These are the

Improved Pension, Homebound and Aid and Attendance.

Eligibility requirements and benefit amounts are available

here (/longtermcare/resources/veterans_pension.html).

Veterans can also get care assistance through Veterans-

Directed HCBS (/longtermcare/resources/veterans-directed-

hcbs.html), a relatively new program that allow for self-

direction of services and the VA Respite Care

(/longtermcare/resources/va_respite_care.html) which can

reduce the home care hours a veteran requires.

State Non-Medicaid Programs

Most states have in-home assistance programs for low income

seniors who are not eligible for Medicaid. These programs

are intended to prevent or delay the placement of needy

individuals in nursing homes and are loosely referred to as

"nursing home diversion programs". Eligibility, benefits and

even sources of funding varies with each program and some

states even have more than one program. As an example of

the diversity, some of these programs provide cash

assistance, others provide care services and respite and still

others provide non-care based, in-home support such as

assistance with chores, meals and transportation. Assistance

with adult day care and assistance for home modifications to

enable aging in place are two other approaches the states

use to help. The common thread amongst all of these

programs is that they help seniors remain living at home or

help families to care seniors in their homes.

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Please follows the links below to read about specific programs

in your state.

State Non-

Arizona NMHCBS (/longtermcare/resources/arizona_nmhcbs.

Alaska Senior Benefits (/longtermcare/resources/ak-senior-b

Alaska Senior Access Program (/longtermcare/resources/ak-

Alaska Adult Day Services (/longtermcare/resources/ak-adul

Alaska Alzheimer’s Mini-Grants (/alzheimers/ak-adrd-mini-gra

Alaska Senior In-Home Services (/home-care/ak-senior-in-ho

California Alzheimer's Day Care

(/longtermcare/resources/california_alzheimers_daycare.htm

California In-Home Supportive Services

(/longtermcare/resources/california_inhome_supportive.html

Colorado Old Age Pension (/longtermcare/resources/colorad

Colorado Home Care Allowance (/home-care/co-home-care-

Connecticut CHCPE (/longtermcare/resources/connecticut_h

Connecticut Adult Family Living / Caregiver Homes (/longter

family-living.html)

Connecticut Choices at Home Project (/longtermcare/resourc

Delaware Adult Day Care and Alzheimer's Day Treatment (/a

care.html)

CARE Delaware (/longtermcare/resources/delaware-care-pr

DC's Senior Citizens' Home Repair (http://www.payingforseni

modifications/dc-senior-citizen-home-repair.html)

Florida OSS for Seniors (/longtermcare/resources/florida_os

Florida Project R.E.L.I.E.F. (/longtermcare/resources/florida_

Florida Alzheimer’s Disease Initiative

(/longtermcare/resources/florida_alzheimers_disease_initiati

Florida CCE Program (/longtermcare/resources/florida_cce.h

Florida Home Care for the Elderly

(/longtermcare/resources/florida_homecare_elderly.html)

Florida Local Services Program (/longtermcare/resources/fl-l

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Georgia Home & Community Based Services (/longtermcare/

hcbs.html%20)

Hawaii Kupuna Care (/longtermcare/resources/hawaii_kapun

Hawaii Chore Services Program (/cash-and-counseling/hi-ch

Idaho Senior Respite (/longtermcare/resources/idaho_senior

Idaho Homemaker Services (/longtermcare/resources/id-hom

Illinois Community Care (/longtermcare/resources/illinois_co

Indiana Choice (/longtermcare/resources/indiana_choice.ht

Iowa Able Foundation Loan Program (/home-modifications/io

Iowa Senior Living - Case Management Program (/home-car

program.html)

Kansas Senior Care Act (/longtermcare/resources/kansas_s

Kentucky Hart-Supported Living (/cash-and-counseling/ky-h

Kentucky Personal Care Attendant (/cash-and-counseling/ky

attendant.html)

Kentucky Adult Day Care and Alzheimer's Respite (/longtermalzheimers-day-care.html)

Maine Home-Based Care (/longtermcare/resources/maine_h

Maryland Senior Care Program

(/longtermcare/resources/maryland_seniorcare_program.ht

Maryland In Home-Aide Services (/longtermcare/resources/m

Massachusetts HCP and ECOP Programs

(/longtermcare/resources/massachusetts_hcp_ecop.html)Minnesota Alternative Care Program

(http://www.payingforseniorcare.com/longtermcare/resources

Mississippi In Home Care Services / Homemaker Program

(http://www.payingforseniorcare.com/home-care/ms-in-home

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Other Options

Families should think not just about programs which offer

assistance but also programs targeting seniors that can

reduce other expenses thereby freeing up financial resources

to put be towards the cost of home care. In this categorythere are a variety of tax credits and deductions. For

example, any expense incurred to care for an elderly relative

that enables the family to work is tax deductible. Read about

other tax credits for elderly (/longtermcare/tax-deductions-

credits-for-seniors-and-elderly-2010-2011.html).

Home care and adult day care are, in

most cases, tax deductible expenses.

Energy costs to heat and cool one's home can take up a

significant portion of low income seniors' fixed incomes.

LIHEAP is a program designed to help seniors with their home

energy bills, which can again free up dollars for home care.

The LIHEAP application has specific filing deadlines which

often give preference to lower income seniors. Learn more

here (/longtermcare/resources/liheap_financial_aid.html).

Non-profit organizations sometimes offer financial or care

assistance for individuals with specific conditions. Explore

programs at the following links for individuals with Alzheimer’s

(/longtermcare/resources/alzheimers_respite_care.html) ,

Cancer (/longtermcare/resources/cancer_co-

payment_assistance.html), Diabetes

(/longtermcare/resources/diabetes-assistance-programs.html), Kidney Disease

(/longtermcare/resources/kidney_patient_assistance.html)

and Leukemia

(/longtermcare/resources/leukemia_lymphona_copay_assistance.

Possibly the easiest and most effective way to reduce home

care expenses is to find affordable care. The hourly rates for

home care can vary by as much as 50% even in the same

geographic area. Our organization provides a free service

that help families to locate quality-screened, affordable care

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providers. Start here (/home-care-assisted-living/find-

affordable-elder-care.html).

Self-Payment Options for Home Care

Reverse Mortgages / HELOCs / Equity Key

There are several ways families can self-pay for care by using

their home as a financial resource, these include reverse

mortgages, home equity lines of credit and Rex Agreements.

However, depending on marital status, severity of need and

the projected length of need not each of these options

necessarily makes economic sense. For example, if the

person in need of care is single and may need to move into

residential care within a two year period, then a reversemortgage is probably not the best option. The same applies

to Rex Agreements. One can read more about when it is best

to use each of these options and their pros & cons at the

following links: Reverse Mortgages

(/longtermcare/resources/reverse_mortgages.html), Home

Equity Lines of Credit (/longtermcare/resources/heloc.html),

Rex Agreements

(/longtermcare/resources/rex_agreement.html).

Life Insurance Policy Conversions

Life insurances holders have a variety of ways of converting

their policy into cash or home care services prior to the

policyholder's passing. There are three options that allow

individuals to stop making premium payments and receive

immediate payouts on their policies without passing. Viaticalsettlements are designed for individuals with less than 2 year

life expectancy. Life settlements are intended for persons

with longer life expectancies. Life insurance conversions give

consumer the greatest value for their life insurance policy

however the benefit comes in the form of care services

instead of cash. Pros, cons and eligibility information is

available for viaticals

(/longtermcare/resources/viatical_settlements.html), life

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settlements (/longtermcare/resources/life_settlements.html)

and conversion programs (/longtermcare/lifecare-assurance-

benefit-plan.html).

Life insurance policies can beconverted into home care services,

preserving the policyholder's eligibility for Medicaid. Learn more (/longtermcare/lifecare-assurance-benefit-plan.html).

Accelerated death benefits

(/longtermcare/resources/accelerated_death_benefits.html)

and death benefit loans

(/longtermcare/resources/death_benefit_loans.html) are two

other ways individuals can receive cash for the life insurance

in advance of their death. However, with these two options,

the policyholder must continue to make their monthly premium

payments.

Home Care Loans

Loans specifically designed for elder care are a new and

interesting financial product. These loans are intended for

short term needs while a family is waiting for other financing.

For example, a veteran's pension claim approval can take 6-

12 month, but once it is approved, it is paid in a retroactive

lump sum back to their claim filing date. A loan is made to

these individuals with the expectation that it will be re-paid for

the lump sum. A similar situation exists for families selling a

home and having the elderly relative move in with the adultchildren. Finances will become available it is just a matter of

when the home will sell. For more information on fees, pros

and cons for home care loans, click here

(/longtermcare/resources/bridge_loans.html).

Long Term Care Insurance

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Individuals with long term care insurance can use the benefits

to pay for home care. For persons without LTC insurance

who have a need for care, they typically are not eligible to

purchase insurance. For this reason our discussion of LTC

insurance (/longtermcare/resources/ltc_insurance.html) is

relevant only to persons doing very long term planning.

Finding Affordable Home Care

There is a great deal of variation in the cost of home care not

just amongst the states but even in the same geographic area

within a state. A recent study found in most areas, there are

care providers who charge as much as 50% below or above

the average hourly rate for that area. This means the choice

of care provider is a major factor in affording long term care athome. It is difficulty and time consuming to contact each care

provider in the area and determine their rates. For this

reason, we've partnered to provide a free service that helps

families find the most affordable home care in their area. Start

here (/home-care-assisted-living/find-affordable-elder-

care.html).

Developing a Financial Plan for Home Care

Since many families pay for home care from their savings,

they are in a state of continuously diminishing resources.

Many assistance programs determine eligibility based on an

individual’s resources. Therefore, the assistance available to

an individual is constantly changing. In other words, the

longer a person requires (or is projected to require) home

care, the more assistance that becomes available to them.

For this reason (and others), it is advantageous to develop a

long term financial plan when considering home care. Doing

so has the dual benefit of ensuring a comfortable and

consistent aging process for your loved one while at the same

time preserving your family’s assets and resources.

The creation of a financial plan for home care is a

complicated process and must accommodate various health

scenarios. Fortunately, there are resources available to help

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families with financial planning for home care. A complete

exploration of one's care planning option is available here

(/longtermcare/find_provider.html) and summary follows

below. Each option has its pros and cons.

Public Benefits Counselors – local Area Agencies on

Aging (AAA) and Aging and Disability Resource Centers

(ADRC) have benefits counselors on staff that can help

with financial planning. While they typically do not charge

for their assistance, they may be under-staffed and

unable to provide adequate long term planning. They also

tend to be highly knowledgeable about local programs but

have less larger financial planning experience. Find your

local AAA or ADRC

(/longtermcare/find_aging_agencies_adrc_aaa.html).

Geriatric Care Managers – GCMs help families create

and implement long term care plans and, as a part of that,

some will help with financial planning. Since GCMs are

typically paid for out-of-pocket, one can expect a higher level of attention than one might receive from a public

benefits counselor. Families tend to contact GCMs only

after the need for care has become apparent and

therefore GCMs are not in the best position to do long

term planning. Often GCMs come from nursing or public

health backgrounds and do not have extension financial

experience. Find a Geriatric Care Manager

(/longtermcare/find_geriatric_care_managers.html).

Eldercare Resource Planners - ERPs are specialists in

developing financial plans for home care. They differ

from Care Managers in that they typically come from a

financial background instead of healthcare background.

They are paid out-of-pocket but can often pay for

themselves in the financial assistance resources they

discover for their clients. They are significantly less

expensive than Elderlaw attorneys, but cannot perform

some of the legal procedures which only attorneys can.

Learn more

(/longtermcare/find_eldercare_resources_planners.html).Elderlaw Attorneys - the most expensive and most

thorough option. An elderlaw attorney and their staff can

provide a one-stop shop for home care financial planning

but their hourly rate may prove cost-prohibitive for some

families. One can search the National Academy of Elder

Law Attorney database here

(https://www.naela.org/Public/About/For_More_Information/Fin

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State-by-State Home Care Costs and Affordability Index

This table contains the average hourly cost of home care

aides for all 50 states and D.C. In addition, it contains our

experimental home care affordability index* which considers

the cost of home care in a state relative to its median

household income. The state’s ranking out of 50 states andWashington D.C. is contained in the final column.

2015 Home Care Costs and

State Home Care Hourly Rate Home Care

Lower #s are

United States $20

Alabama $16

Alaska $26

Arizona $20

Arkansas $17

California $23

Colorado $22

Connecticut $20

Delaware $20

District of

Columbia

$20

Florida $18

Georgia $18

Hawaii $24

Idaho $19

Illinois $21

Indiana $19

Iowa $22

Kansas $19

Kentucky $19

Louisiana $15

Maine $22

Maryland $20

Massachusetts $24

Michigan $20

Minnesota $24

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Copyright © 2015. All rights reserved. Use or replication of this content by other web sites or commercial

Mississippi $16

Missouri $19

Montana $23

Nebraska $22

Nevada $21

New Hampshire $23

New Jersey $20

New Mexico $19

New York $21

North Carolina $18

North Dakota $26

Ohio $19

Oklahoma $19

Oregon $22

Pennsylvania $20

Rhode Island $24

South Carolina $18

South Dakota $22

Tennessee $18

Texas $19

Utah $21

Vermont $21

Virginia $18

Washington $24

West Virginia $16

Wisconsin $21

Wyoming $20

*Data provided by Genworth Financial, Inc. (NYSE:GNW) and the US Census

Bureau

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entities without written permission is strictly prohibited. This site is for information and support; it is not a

substitute for professional advice. Every effort is made to provide accurate and up to date information. Please

notify us (/contact-us.html) of inaccuracies.