Eldercare Financial Assistance Locator Tool


There are over 400 programs which provide financial assistance for elder care.  Help comes from federal, state and local governments, the VA, non-profits, private organizations and as many as 50 other agencies.   The large number of sources and the different and often conflicting qualification rules makes determining one's eligibility a difficult challenge.

By answering the following questions, we will help you to find the programs for which you or your loved one is currently eligible as well as those programs for which you might become eligible as your situation changes.

 

Tips for Completing this Form

1) Questions are optional and all information is confidential.  However not answering a question prevents us from using that information to sort your results.

2) Your results will be available within 1-2 minutes and are also sent by email so you may reference them at any time without having to re-complete this form.

3) Most browsers don't retain your answers when using the Back Button so it is best to complete the form thoroughly the first time.


1. What is the age of the individual that requires care?
Under 60 years old
60-61 years old
62-64 years old
65-74 years old
75-84 years old
Over 85 years old
2. Is the individual in need of care yourself, your spouse, one of your parents or another loved one?
Yourself
Your spouse
A parent
Other loved one
3. What is the current marital status of the person that requires care? Please read all the options before selecting one.
Married
Widow / Widower
Divorced and not re-married
Divorced or widowed and re-married before age of 60
Divorced or widowed and re-married after age of 60
Never Married
4. Some resources and programs are only available for specific purposes. Select "No" for those resource categories you do not wish to include in your results.
YesNo
       Help with assisted living / adult foster care
       Help with skilled nursing care
       Help with in-home care
       Help with adult day care
       Help with durable medical equipment or supplies
       Help with home safety and accessibility improvements
       Help with long term care insurance
       Help with existing medical bills
       Help with prescription drug costs
       Other Reason  
5. What is the annual income of the individual in need?
Less than $10,000 or no income
Between $10,000 and $19,999
Between $20,000 and $29,999
Between $30,000 and $50,000
Over $50,000
6. What are the total assets of the individual in need of care not including their home? If married, divide by two.
Less than $10,000
Between $10,000 and $24,999
Between $25,000 and $49,999
Between $50,000 and $100,000
Over $100,000
7. Does the individual in need of care own and live in their home? Please read all the options before selecting one.
They own their home and live in it alone
They own their home and live in it with a spouse
They own their home, but they do not live in it or are moving from it into a care facility
They own their home, but they are moving into a care facility and their spouse will remain at home
They do not own a home
8. Has the individual in need of care been injured in an accident or fall recently outside of their home or property that resulted in an increased need for care? If so, they may be entitled to assistance or compensation.
YesNo
       Yes, they were injured in a fall outside their home / property
       Yes, they were injured in a vehicle accident
       Yes, they were injured in a pedestrian accident
       Yes, they were injured by a defective product.
       Yes, they were injured in some other type of accident
       No, they have not been injured or were injured at home
9. How soon are the financial resources required?
Immediately
Within 3 months
Within 6 months
No defined period
10. There are tax credits and deductions available to the elderly and their families depending on how they decide to file their taxes. Can the individual in need of care files taxes in any of the following ways?
YesNo
       They can file in at least one of these ways: as an individual, a married couple or a married couple filing separately.
       They can be claimed as a dependent on someone else's return
11. Is the individual in need of care a veteran or the widow / widower of a veteran? And if so, were they a wartime veteran?
Veteran
Widow / Widower of a Veteran
Wartime Veteran
Widow / Widower of a Wartime Veteran
Not a Veteran
12. What is the health status of the person that needs care?
Good Health: Can live independently without assistance
Moderate Health: Requires assistance with some daily living activities but does not require 24hr supervision
Poor Health: Requires help with activities such as dressing, bathing and taking medication; may enter residential care
Terminally III: Has a deteriorating condition that requires continuous medical monitoring; they require skilled nursing care
13. Does the individual in need of care have a life insurance policy valued at over 50,000 dollars?
Yes
No
14. There are programs available to help with insurance premiums and co-payments for procedures and medications. However, one must have insurance to be eligible. Choose all the types of insurance the individual in need of care currently has.
YesNo
       Medicare
       Medigap Plan
       Medicare Advantage Plan
       TRICARE / TFL or CHAMPVA / CFL
       Other Private Health Insurance
       Long Term Care Insurance
       Has no insurance
15. Some resources are only available to individuals diagnosed with specific conditions. Does the individual in need of care have any of the following conditions? Choose all that apply.
YesNo
       Alzheimer's Disease or Dementia
       Broken / Fractured Bone (hip, arm, leg, wrist etc.)
       Cancer
       Chronic Kidney Disease
       Diabetes
       Heart Disease or Heart Attack
       Hemophilia, Cystic Fibrosis, Spinal Cord Injuries or Multiple Sclerosis
       Leukemia, Lymphoma, Myeloma or Myelodysplastic Syndromes
       Mesothelioma
       Rheumatoid Arthritis
       Stroke
       None of these conditions
16. The number and location of one's children can impact a senior's eligibility for some programs. Does the individual in need of care have children of any age?
No they don't have children
Yes, they have children that live out-of-state
Yes, they have children that live in-state
Yes, they have children that live both in and out-of-state
17. How long do you expect to require the additional financial resources?
Less than 6 months
6 months to 2 years
2 years to 5 years
Longer than 5 years
18. Has the individual in need of care taken any of the following prescription drugs in the past 3 years? Choose all that apply.
YesNo
       Avandia or Actos - prescribed for diabetes
       Crestor - prescribed for high cholesterol
       Fosamax - prescribed for osteoporosis (loss of bone density)
       Neurontin - prescribed for lingering pain after shingles (postherpetic neuralgia or PHN)
       Reglan / Metoclopramide - prescribed for heartburn or gastroesophageal reflux
       Zyprexa - prescribed for dementia, Alzheimer's or schizophrenia
       Vioxx - prescribed for arthritis and pain
       None of the above
19. In what city and state does the individual in need of care currently reside?
City:*   State:*   Zip:*   
20. Please provide us with an email address to which we can send the customized results
Email:*   
 Check here to receive assistance finding affordable care.


First Name:*
Last Name:*
Phone:*
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  Wartime veterans served for at least 90 days and 1 day of which was during the wartime dates below, but not necessarily in combat.
-World War II: Dec 7, 1941 - Dec 31, 1946
-Korean War: Jun 27, 1950 - Jan 31, 1955
-Vietnam War: Aug 5, 1964 - May 7, 1975
-Gulf War: Aug 2, 1990 - Undetermined