Reducing In-Home Care Costs

In the previous issue “A Priceless Conversation”, we discussed if the help from a family member alone is enough or whether in-home Caregivers or an outside facility might be a consideration. There’s more to providing care than just family agreement that help is needed, there’s also the challenge of how to pay for it. What are the cost’s, who pays for it, can government agency pay for some of the costs, what’s the difference in cost between in-home care and an Assisted Living facility, who knows the answers?



There are two factors to consider; the cost of in-home care or the cost of an avoidable crisis. Once a serious injury or illness occurs, costs can quickly get out of control and even with Medicare, the cost of health care can be paralyzing.


No matter what level of care you’re considering, there is an associated expense. For example an Assisted Living Facility runs about $1,000 per week and up, Board and Care costs less than an Assisted Living Facility and in-home care offers the most cost control since care can range from a few hours a day to round the clock service. An Assisted Living Facility or Board and Care can offer social benefits (seniors around other seniors) but that also means giving up your home and independence or not receiving one-on-one care. Agencies like Senior Helpers and others can provide socialization via transportation to visit friends, relatives, church, go shopping, see doctor’s, allow you to sleep in your own bed and receive many other services as well.


Often in-home care is avoided in an effort to save money but the cost of hospitalization from a simple fall can be sobering and most are unprepared for the impact. I recently sat down with Peggy Rossi, Case Manager (RN, MPA, CCM, CPUR) at Mercy San Juan Hospital in Carmichael and discussed the financial challenges with the cost of health care. “Most families are not familiar with the benefits and limitations of their medical policies.” Medical policies in this case are Long Term Care, Medicare part A and B, Medigap Policies or Veterans benefits.


Did you know that if you are admitted to a hospital for fainting, you might be provided with observation or custodial care versus skilled care and in this circumstance, Medicare will likely deny coverage. Peggy Rossi explains it this way: you are given a hospital bed, get x-rays, lab work, see doctors and nurses, but Medicare doesn’t pay for this level of care! Yikes, did I read this right? You did and you could be on the hook!


If affordability is what’s holding you back from in-home care, there are a number of resources available. If you have a Long Term Care policy, contact a representative to learn if your policy includes in-home care. If you are a Veteran or spouse, you may be eligible for “Aid and Attendance” which may enable you to receive in-home care. You may also qualify for MediCal benefits but you’ll need to understand the application process.


You may be denied or only qualify for limited benefits if your income is considered too high. In this event, you might consider restructuring your assets into a family trust or conservatorship. This may help you qualify for Medi-Cal or Aid and Attendance without spending down all of your assets to do so. There are also new (no cost) bridge loans for Aid and Attendance available through Senior Helpers that will help you during the waiting period.


Senior Helpers often refers clients to discuss these asset strategies with a qualified eldercare attorney. A family trust is helpful if you plan to leave your estate to a family member and you honestly trust them. If this is not the case, you could place your estate in a legal conservatorship.


For more information on Veterans benefits call 916-780-3296, for Medi-Cal questions 800-430-4263, for Medigap insurance visit http://www.medicare.gov/medigap/default.asp.


One cautionary note, if you wait too long to acquire in-home help, end up in the hospital and then try to move assets around to avoid a medical bill through Medi-Cal or Medigap you will likely be too late and your application could get rejected. If you have questions or feel overwhelmed about how to get care or find resources to pay for it, contact Senior Helpers at 916-671-5777, we’re here to help.


There’s more than a 50% chance you could end up in a long term care facility in your life time. Find out what challenges Case Managers face in discharge planning at local skilled nursing and rehabilitation facilities, in the next issue of Senior Magazine.