How to Get Financial Help for Assisted Living

Many people cannot take care of their elderly parents or disabled loved ones. Sometimes, they cannot get into a nursing home, or you do not want to put them there, but they cannot care for themselves on their own. How can you pay for it? Assisted living is cheaper than a nursing home, but it is still prohibitively expensive.

Instructions

Determine How Much is Already Available to Pay for Assisted Living

1. Figure out how much money the person has available to pay expenses each month before you begin to consider assisted living.

2. Decide whether or not you even have a legal right to make these decisions. Unless you have durable power of attorney or the patient is incapacitated and you have been appointed guardian, you might not be able to do anything. If you are not sure, consult either an elder care attorney or a social worker with the local human services bureau.

3. Inquire at a few assisted living facilities about the daily, monthly and yearly costs of living at their facility. Prepare for a great deal of paperwork and phone calls.

4. Organize the financial information or assist the patient in organizing it so that every insurance policy, savings account, stock fund or other asset is itemized to determine how long those assets can assist, and how much of those assets are liquid (meaning immediately convertible into cash).

Find Out About Federal and State Programs

1. Realize that there are two types of options to make assisted living more affordable. Some of these options cover services the resident may require, and others subsidize the cost of living.

2. Inquire with Social Security income programs to cover services. The amount that SSI will cover will vary based upon how much a state will allow SSI to cover. However, SSI will be a good point of contact for other sources of funding.

3. Follow up with your state Medicaid program to see what services will be subsidized. Assisted living may not be covered, but many states will offer a waiver program to assist in paying for assisted living.

4. Ask Medicaid representatives about home and community-based services waivers. The HCBS program provides mutual assurances between Medicaid and state-based Medicaid agencies that this is the cheaper alternative and the waiver is not being abused.

5. Determine whether your loved one is eligible for Medicaid, as this is normally the marker for eligibility for HCBS waiver programs. It will not cover the whole cost, but it will help.

6. Note that personal care services, which used to be covered only with a prescription, are now written into the new federal regulations such that medicaid gives explicit permission for state programs to cover personal care services both inside and outside the home.

7. Decide whether you are able to relocate if necessary for affordability. Maine, Vermont and Florida offer private, non-medical institutions (PNMIs), which provide medical care to its residents through contracts or other arrangements with medical providers, and receives capitation payments from the medicaid agency under a non-risk contract. CMS (the organization that replaced HCFA as oversight of these programs) has approved licensing rules for these types of facilities, and seeks to ensure that the level of care is adequate and in line with medicaid goals.

Look at Different Options for Room and Board Expenses

1. Realize that Medicaid and SSI cannot pay for room and board, which is the largest portion of the expense of these facilities.

2. Note that eligibility for the HCBS and PCS waivers is usually only available to low or moderate income individuals.

3. Look into HUD Section 8 Housing. These programs are designed to assist low-income families, older persons and persons with disabilities to pay for decent and safe housing. Subsidies for assisted living facilities fall under the goals of this program. Residents must pay at least 30 percent, but not more than 40 percent of their income for housing costs. In addition, the income of the claimant for Section 8 subsidy must be below 50 percent of the median income of the county or metropolitan area where the resident chooses to live. Also, consider a HUD Section 202 Conversion Fund. HUD Section 202 Funds are now available to convert housing or other real estate into assisted living facilities for low or very-low income residents. Unlike a HUD Section 8 voucher, these payments go right from the government to the facility. This is not direct funding to the patient, but can assist in lowering assisted living costs.

4. Think about using a Low Income Housing Tax Credit. These may only be used on qualified low-income buildings that are residential buildings. If your desired facility is not using these credits, showing the credit to them can help defray the costs.

Inquire at Local Human Services Offices and Charities

1. Consider that in addition to your own funds, other agencies in your neighborhood are looking for people to help. Think about whether or not local religious charities, especially ones where the patient may have worked, may be able to assist.

2. Call agencies like the United Way to find out about additional sources of funding in your area.

3. Inquire about whether there are support organizations for patients with similar maladies to your loved one, such as Alzheimer's, senile dementia and COPD. Sometimes, these organizations can actually assist in securing additional charitable contributions to defray the costs of assisted living.

4. Recruit friends and family members to assist in your search. There will always be someplace you didn't think of, and you could always use the help instead of trying to handle the burden on your own.

5. Discuss the options with the patient, with your family, and with the assisted living facility staff. Other ideas you may have overlooked might come up while you wait for a spot to open up.

Tips & Warnings

• Research local assisted living facilities through friends, relatives and through local human services offices before you consider placement there.

• Assisted living facilities can often have waiting lists of a year to three years, so the time you wait is the time to do your homework.

• Any expenses that you incur as part of caring for the loved one may be deductible from your income taxes, and while it is little comfort in the short-term, it could lower your tax bracket one or two notches in the reporting year, which may put a lot more money back in your pocket to help defray future costs.

• Do not begin to delve into the finances of the patient without his or her permission. In the absence of guardianship or durable power of attorney, this could get you in hot water, not only with the person you want to help, but with the law.