Common Misperceptions about Paying for Long Term Care

To alleviate some of the confusion about programs that help with eldercare, we maintain this page which discusses common misconceptions about who pays for nursing home care, assisted living and home care. Also discussed are programs in development that one may have heard of but are not relevant to a wider audience.

1. Medicare's Benefits

Many people assume Medicare will pay for assisted living, Alzheimer's / dementia, and other long-term care. It does not. At best, Medicare will help pay for short-term skilled nursing.  Read a summary of Medicare’s Long Term Care benefits.

2. Eldercare Costs the Same Everywhere

There is a very large cost difference in home care, assisted living and nursing home care in different states, within the same state and even within the same city or town. From state to state the cost of residential care can vary over 300%. Within a state, one will find certain areas where the cost is twice as expensive as other areas, but most important is that the cost within the same area can be 50% higher or lower. For families, this is good news. By shopping around, it easily possible to dramatically lower one's care costs. Our organization has partnered to provide a free service which helps families to find the most affordable, yet high-quality care in their geographic area. Get help finding affordable care.

3. Money Follows the Person (MFP)

This program is only for Medicaid-qualified individuals who currently live in nursing homes and wish to move into the homes of their families or the community. Learn more about the Money Follows the Person program and if it is available in your state and relevant to your situation.

4. Affordable Care Act (ACA)

This Act, more commonly referred to as Obamacare, is umbrella legislation that reforms many aspects of health care but does not specifically provide financial resources to individuals.  In fact, despite the Medicaid expansion, the Affordable Care Act does very little to impact long-term care benefits for the elderly.

5. Social Security Disability Insurance (SSDI)

SSDI is not an option for seniors, rather it is a program designed for those younger than 67 years old. Read more about SSDI here.

6. Older Americans Act

This act provides funding to state and local agencies called Area Agencies on Aging, which provide services that help seniors remain in their homes longer. Examples include meal services, in-home services, and transportation. It does not provide money for long-term care to individuals directly.

7. Community Living Program Grants

These grants are provided to the states for the development of programs; these grants are not direct assistance provided to families. However, families may still benefit indirectly from these programs; read more about Community Living Grants and Nursing Home Diversion programs.

8. The CLASS Act

The CLASS Act was a government sponsored long-term care insurance program. However, the law that provided for this program was repealed.  It is not expected to come into law again, nor will it have a positive financial impact for seniors for several years to come.  Read more about The CLASS Act.

9. Alzheimer’s Disease Supportive Services Program

The Alzheimer’s Disease Supportive Services Program (ADSSP) / Alzheimer’s Disease Demonstration Grants are a series of grants made by the Administration on Aging to various community non-profits, agencies, and educational institutions.   These grants are provided for the development of programs, which assist caregivers largely in the area of training and less so with providing of care services.  Grants are not provided to individuals directly.  Instead, they are made to partners for the development of new and experimental programs.  Some of the programs funded do assist caregivers directly, though again, not with care services, but caregiver training.   These programs include REACH II, Savvy Caregiver, and Star-Caregiver.  

10. Family and Medical Leave Act

The Family and Medical Leave Act (FMLA) is a government program that allows people to take time off from their jobs to care for their loved ones without fear of losing their job or their health insurance.  However, the FMLA does not pay family members to care for their loved ones.  Read about the FMLA.

11. The Caregiver Advise, Record, Enable (CARE) Act

While valuable and well meaning, the CARE Act does not provide financial assistance for care or caregivers. What the program does do is to have hospitals append the name of a patient’s family caregiver to their medical record. When the patient is being discharged from the hospital, the family caregiver will be informed, and they will be provided with education and training for any medical tasks they will be required to perform as a caregiver. At the time of last update to this article, The CARE Act had been adopted by thirty states.

12. Medicare Long-Term Care Services and Supports Act of 2018

This proposal is just a proposal, it has not been signed into law and it is very uncertain at this point whether the proposal would be signed into law as its benefits are controversial and do not enjoy broad bi-partisan support. That said, should the Act be passed into law, it would provide a significant cash benefit to Medicare beneficiaries that can help pay for nursing home care or a broad array of in-home support services that would help beneficiaries avoid nursing home placement. At the very earliest, should the proposal become law, the benefit would not be available until 2023.