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Financial Options to Help Pay for or Reduce the Cost of Home Care


Costs of Home Care and Home
Health Care
Find Affordable
Home Care

Home Care Financial
Resource Locator Tool

Paying For Home Care
Developing a Financial Plan
 for Home Care

50-State Home Care
Costs & Affordability Index


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 or non-medical care, helping seniors with their activities of daily living such as bathing, dressing, housekeeping and transportation.  Home Health Aides offer skilled care such as checking patients’ pulses, temperature or respiration. They assist with medications, braces, ventilators and other medical equipment and can provide higher level skilled nursing as well.
 
Costs of Home Care and Home Health Care
Both home care aides and home health aides bill on an hourly basis.   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.  

A home care aide will typically visit an individual several times a week for periods lasting from 2-8 hours.  Nationwide, the average hourly fee is $19 and different state averages range from $13 - $29.  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.

Home Health Aides will visit the home as much as medically necessary; typically for shorter periods of time than home care aide visits.  Nationwide, the average hourly fee is $21 and different state averages range from $13 - $34. 

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 which is not the case in senior living residences.

Find affordable home care, see a table of the average cost of home care and home health care by state or use our home care vs assisted living calculator.


Paying for Home Care
Home care aides provide personal care rather than medical care.  Therefore, health insurance and Medicare do not help with these costs.  Families most commonly use Social Security, Veterans and other pensions, their savings and home equity through a reverse mortgage to pay for care.   For those fortunate enough to have long term care insurance, some plans include allowances for personal care.   Provided a set of requirements are met, life insurance policies may be converted to cash and used for home care as well.   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.

Financial Assistance for Home Care
It is beneficial to group the forms of financial or care assistance that can be used to reduce the costs of home care into several categories.  You may wish to use the Home Care Financial Resource Locator Tool to automatically determine which of these programs are available and relevant to your current situation.

Alternatively, you can explore these programs and options by clicking the links below.

1.     Federal Programs (non-Medicaid) – These are federally managed options that provide financial or care assistance, or they cover some of the cost of home care.

Cash and Counseling Program

Lifespan Respite Care Program

Medicaid

Medicare

Medicare Savings Programs

Social Security

SSI State Supplements

Supplemental Security Income

Survivors’ Benefits

Veterans Health Care

Veterans Pensions


2.     Cost of Living / Care Reductions – These programs and tax credits can reduce a family’s tax burden or reduce the hours of care required effectively lowering the overall cost of care.

Alzheimer’s Respite Care

Elderly and Disabled Tax Credit

Federal Elderly Care Tax Credit

LIHEAP – Aid for Energy Costs

Medical Expense Tax Deductions

NFCSP Respite Care

State Elderly Care Tax Credit

Veteran’s Administration Respite Care

 

3.     Asset Conversion Programs – These options provide families that have non-liquid assets with a method by which to convert those assets to help pay for care.

Accelerated Death Benefit

Death Benefit Loans

Equity Key

Family / Friends Loans

Home Equity Line Of Credit

Life Settlements

Reverse Mortgages

Rex Agreement

Viatical Settlements

Life Care Assurance Benefit

 

4.     Non-Profit Assistance – For qualified individuals, these programs provide financial assistance and / or respite care.

Alzheimer’s Respite Care

Cancer Co-Pay Assistance

CFAC: Cancer Assistance

Financial Aid for Kidney Patients

Leukemia & Lymphoma Society Aid


5.     State Programs – These are options managed by the states that provide financial assistance or cover some of the cost of home care.

Arizona NMHCBS

California In-Home Supportive Services

Colorado Old Age Pension

Connecticut CHCPE

Florida CCE Program

Florida HCE

Florida OSS For Seniors

Hawaii Kupuna Care

Illinois Circuit Breaker Tax Relief

Illinois Community Care

Indiana CHOICE

Kansas Senior Care Act

Maine Home-Based Care

Maryland In Home-Aide Services

Maryland Senior Care Program

Massachusetts HCP and ECOP Programs

Minnesota Alternative Care

New Hampshire Transitions in Caregiving

New York Expanded In-home Services for the Elderly (EISEP)

Nevada CHIP and COPE

New Jersey JACC Program

Texas CCAD Program

Texas Community Attendant Services

Texas DADS Services to Assist Independent Living

Texas In-Home and Family Support

Utah The Alternatives Program

Virginia Adult Services

West Virginia Family Alzheimer’s In-Home Respite 

West Virginia Lighthouse Program

Wisconsin COP

Wisconsin SSI-E

Wyoming CBIHS

 

6.     Medicaid Programs – Often labeled “nursing home diversion” programs, the intent of most of these programs is to keep the elderly out of nursing homes and instead living at home.  These programs will pay for home care provided it can be obtained for a lesser cost than in a nursing home. There are very strict financial eligibility requirements for Medicaid.


AK - Older Alaskans Program
MO - Aged and Disabled Waiver
AL - Elderly & Disabled Waiver
MS - Elderly and Disabled Waiver
AL - Technology Assisted Waiver for AdultsMT - Elderly/Physically Disabled HCBS Waiver

MT - Self-Directed Personal Assistance Services
AR - IndependentChoices WaiverNC - Community Alternatives Program
AR - DAAS ElderChoices
ND - HCBS for Aged and Disabled
AZ - Health Care Cost Containment System - 1115
AZ - Nursing Facility / Acute Hospital
CA - Multipurpose Senior Services Program
NE - Home and Community Services Aged & Disabled
CO - HCBS Waiver for the Elderly, Blind or Disabled
NH - Choices for Independence
CT - CT Home Care Program for Elders (CHCPE)
NJ - Global Options Waiver (GO)
CT - Money Follows the Person (MFP) ProgramNM - CoLTS C Waiver
DC - Elderly and Persons with Disabilities (EPD)NV - HCB Waiver for the Frail Elderly
DE - Medicaid Waiver for the Elderly and Disabled
NY - Managed Long Term Care Program Waiver (MLTC)

NY - Consumer-Directed Personal Assistance
FL - Aged and Disabled Adult Waiver
OH - PASSPORT
FL - Nursing Home Diversion (NHD) Waiver
OK - ADvantage Program
FL - CDC+ Waiver
OR - Aged and Physically Disabled Waiver
GA - SOURCE WaiverPA - HCBW for Individuals Aged 60 & Over
GA - Community Care Services ProgramRI - Personal Choice Plan
HI - Nursing Home without WallsSC - Elderly/Disabled (Community Choices)
IA - Elderly Waiver
SD - HCBS Elderly Waiver
ID - Aged and Disabled Waiver (A&D)
TN - Statewide Elderly and Disabled HCBS
IL - HCBS Waiver for the Elderly
TX - Star Plus
IN - Aged and Disabled WaiverTX - Community Based Alternatives Waiver

TX - Primary Home Care
KS - Frail and Elderly Waiver
UT - Waiver for Individuals Age 65 or Older
KY - Home and Community Based Waiver
VA - Elderly or Disabled with Consumer Direction
LA - Elderly and Disabled Adult Waiver
VT - Choices for Care
LA - Long Term Personal Care Services Program
WA - COPES Aged/Disabled
LA - Adult Day Health Care (ADHC) Waiver
WA - Medically Needy In Home
LA - Community Choices Waiver

MA - Frail Elder Home and Community-Based Services
WI - Community Integration Program-II and COP
MA - Caregiver Homes

MD - HCB Waiver for Older Adults
WV - Medicaid Aged and Disabled Waiver (ADW)
ME - Aged/Disabled
WV - Medicaid Personal Care
ME - Consumer Directed Attendant Services

MI - Michigan Choice Waiver
WY - Home and Community Based Waiver
MN - Elderly Waiver (EW)



Home Care Financial Resource Locator Tool
The Home Care Financial Resource Locator Tool consists of a series of questions that are used to narrow down the many options in our database to only those that are relevant to your specific situation.  Those options and resources for which you are not eligible are also included in a separate column so that you will have a comprehensive picture of the available options and you can determine for what reason you are not eligible.  Click here to use Home Care Financial Resource Locator Tool

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,usually 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 families with financial planning for home care.  Each resource has its pros and cons.   

•    Public Benefits Counselors – local agencies such as Area Agencies on Aging and Aging and Disability Resource Centers have benefits counselors on staff that often can help with financial planning.   While they typically do not charge for their assistance, they are often under-staffed and unable to provide adequate long term planning.  They also tend to be highly knowledgeable about local programs but may not have the larger financial planning experience.  Find your local Agency on Aging or Aging and Disability Resource Centers.

•    Geriatric Care Managers – GCMs help families create and implement long term care plans and, as a part of that, some will help on the financial planning side.  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.

•    Eldercare Financial Planners – Financial planners have the highest level of professional experience and are the most expensive option.  They are very knowledgeable with long term planning but may be less aware of local programs, short term options and ways to reduce the cost of care.  Find an Eldercare Financial Planner .
 
Home Care Service Providers Are Also Known As:

 •    Home care aides are also referred to as personal care aides, caregivers, companions, and personal attendants.

•    Home health aides are also referred to as nurse aides, nursing assistants, certified nursing assistants and geriatric aides.


State-by-State Home Care Costs and Affordability Index
This table contains the average hourly cost of home care aides and home health aide for all 50 states.  In addition, it contains a home care affordability index* which considers the cost of home care in a state relative to the average income.  The state’s ranking out of 50 states is contained in the final column.

State Home Care Aide Hourly Rate Home Health Aide Hourly Rate Home Care Affordability Index Home Care Affordability Index Rank*
Alabama $15 $15 1.78 50
Alaska $25 $25 1.11 10
Arizona $19 $20 1.13 15
Arkansas $16 $17 1.54 49
California $20 $21 1.13 17
Colorado $20 $21 1.15 18
Connecticut $19 $22 0.87 1
Delaware $20 $21 1.16 20
Florida $17 $18 1.04 8
Georgia $17 $17 1.16 22
Hawaii $20 $23 1.25 32
Idaho $17 $17 1.25 30
Illinois $19 $20 1.11 11
Indiana $18 $19 1.26 34
Iowa $20 $20 1.31 41
Kansas $18 $18 1.12 13
Kentucky $16 $17 1.21 27
Louisiana $15 $16 1.02 7
Maine $20 $23 1.46 47
Maryland $19 $20 0.97 5
Massachusetts $23 $24 1.10 9
Michigan $19 $19 1.24 29
Minnesota $22 $25 1.31 42
Mississippi $16 $16 1.27 36
Missouri $18 $18 1.20 24
Montana $19 $20 1.37 45
Nebraska $17 $19 1.13 16
Nevada $20 $21 1.16 21
New Jersey $19 $20 0.91 3
New Mexico $18 $19 1.34 44
New York $20 $21 0.99 6
New Hampshire $22 $24 1.27 35
North Carolina $17 $18 1.19 23
North Dakota $22 $22 1.44 46
Ohio $18 $19 1.21 28
Oklahoma $18 $18 1.21 26
Oregon $19 $21 1.32 43
Pennsylvania $19 $20 1.15 19
Rhode Island $19 $25 1.28 38
South Carolina $17 $17 1.25 33
South Dakota $19 $19 1.28 40
Tennessee $17 $18 1.20 25
Texas $18 $18 1.11 12
Utah $20 $21 1.50 48
Vermont $20 $21 1.28 39
Virginia $17 $18 0.97 4
Washington $20 $22 1.25 31
West Virginia $14 $15 1.12 14
Wisconsin $19 $21 1.27 37
Wyoming $16 $17 0.87 2
*Data provided by Genworth Financial, Inc. (NYSE:GNW) and the US Census Bureau


WY - Home and Community Based Waiver
 
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