The average cost of Senior Home Care in the United States is $4,290 a month, according to Genworth Financial’s Cost of Care Survey. For home health care, the cost is higher, at an average of $4,385 a month. However, considering that home health care can include nursing services, it is a more economical option than residential skilled nursing care, which costs an average of $7,513 a month for a shared room and $8,517 for a private room.

Keep in mind that the above figures are the national average. Depending on your location, Senior Home Care can either be significantly less expensive or much more expensive than the listed costs. For example, in Louisiana, Senior Home Care costs an average of $3,218, potentially saving residents over $1,000 a month compared to the national average. However, in Washington, the price for the same services average $5,720 a month. Regardless of one’s state, home health care will almost always be more expensive than basic Senior Home Care because of the medical certifications and training required of the caregivers.

Many seniors and their families find it challenging to pay for care, whether delivered in one’s home or a residential community. Fortunately, there are financial assistance options available for Senior Home Care. Read on to learn more about the available options and if any of them may be able to lessen your financial burden. 

Private Insurance 

In some cases, an individual’s private insurance may cover some of the cost of Senior Home Care. This typically applies to people with long-term care insurance, as most long-term care services, including Senior Home Care, are not covered by regular insurance policies. 

Long-term care insurance is designed to cover Senior Home Care. However, coverage varies depending on the insurance provider, the specific policy, and other factors, including the age of the beneficiary when they signed up for the policy. Often, long-term care insurance will only begin to cover care once the beneficiary needs assistance with at least two ADLs. So those only in need of companion care may not be covered even if they do have long-term care insurance.

Note that purchasing long-term care insurance once you already need care is typically not an option, and if it is, the policy will not cover very much. To learn more about these policies, visit longtermcare.acl.gov. 

Medicaid

For seniors who qualify, Medicaid does pay for Senior Home Care. In order to receive Medicaid coverage of Senior Home Care, seniors must meet the requirements for both medical need and financial need. In some cases, the senior will need to undergo a medical evaluation to prove that they need the level of care they are receiving. 

While home health care that offers the same level of care as a nursing facility is a federally mandated benefit of Medicaid, personal care services are not. So while some states’ Medicaid may cover companion care and personal care assistance, others may only cover home health care. Additionally, the program which delivers assistance can vary. For example, in some states, Senior Home Care is a benefit of standard Medicaid. In other states, residents in need of financial assistance for Senior Home Care will need to access assistance via a Medicaid waiver program.

These Home and Community-Based Waiver programs (HCBS waivers), also known as 1915(c) waivers, allow seniors to self-direct their care to best meet their needs. Often, this means that someone who requires a nursing home level of care can choose to instead receive home health care, and still have the cost covered by Medicaid. Note that while Medicaid is an entitlement benefit, waiver programs are not. Depending on a state’s program laws and budget, some people who qualify for the waiver program may still not receive the benefit or may be placed on a waitlist. 

Medicare

Medicare does not cover standard Senior Home Care, which includes companion care services and personal care assistance. But, it does cover in-home health care, with some limitations, so long as the senior meets a few requirements. 

To be eligible for Medicare coverage of Senior home health care, the senior must: 

• Be under the care of a physician and have a home health care plan that was created and is regularly reviewed by a physician
• Have doctor certification that the patient needs skilled nursing care, therapy services, or is homebound
• Receive care from a home health care agency that is Medicare-certified

While Medicare does not cover personal care services including assistance with ADLs if that is the patient’s only need, it will cover these services if they are delivered in tandem with nursing or therapy services from a Medicare-certified provider. 

Additionally, though Original Medicare does not cover personal care services, some Medicare Advantage policies may. Because Medicare Advantage insurance providers can offer several different types of Medicare Advantage plans, it’s important to look into the details of each plan and make sure that the plan you’re interested in includes Senior Home Care services as a benefit. 

Aid and Attendance Benefit 

Eligible veterans and their spouses may be able to use the Aid and Attendance benefit to help finance their Senior Home Care. The Aid and Attendance benefit is an extra monthly payment that eligible veterans receive in addition to their regular monthly VA pension. While the funds do not directly cover Senior Home Care, the added monthly income is intended for veterans who have care needs. 

In order to qualify for Aid and Attendance, veterans must be receiving a VA pension and meet all of the associated eligibility requirements, plus meet at least one of four separate eligibility requirements. One of these four criteria is needing assistance in performing one’s activities of daily living, so those in need of Senior Home Care are likely to qualify. Some veterans may need a letter from a physician stating that they are in need of assistance before they are approved for Aid and Attendance. 

The amount of assistance that one receives depends on several factors, including how many members are in their household and the overall household income. To learn more about Aid and Attendance and how to apply, visit the VA website. 

Life Insurance 

Though life insurance is intended to benefit the policyholder’s loved ones following their death, in some cases, it may be used to pay for long-term care, including Senior Home Care. Some policies, referred to as hybrid life insurance, are designed to cover long-term care, though the specifics of what care is covered will vary. 

Even those with standard life insurance policies may be able to transfer their current insurance policy to a cash payment. Depending on the specific case, policyholders may be able to surrender their policy to the insurance provider. Or they can sell their policy to a third-party group. In both cases, the cash value is almost guaranteed to be less than the original death benefit-sometimes significantly so. For this reason, it’s worth having a family discussion about whether transferring a life insurance policy to cash is the right decision. Some people may be better off keeping their life insurance policy as-is. Some may be unable to surrender or sell their policy, depending on the insurance company’s rules. 

Reverse Mortgage Loans

Adults age 62 and older have the option of taking out a reverse mortgage to help finance long-term care, or any other expenses. These loans convert part of the value of one’s home to cash, so they are essentially a cash advance on the home’s equity. Oftentimes, the money received from a reverse mortgage loan is not taxed. This can give seniors some liquid cash to pay for long-term care without needing to sell their home prematurely. This makes it particularly useful for those using Senior Home Care services. 

There are several kinds of reverse mortgages. But the only one that is federally-insured is the Home Equity Conversion Mortgage (HECM). No matter which type of reverse mortgage you choose, you will need to repay it when the last surviving borrower passes away or moves out of the home. Keep in mind that you will have to pay interest on the loan. And borrowing against the home’s value means that you most likely won’t be able to leave the home or the money from its sale to your heirs. Still, reverse mortgages can be a great way to access liquid cash, so long as the borrower is aware of the above stipulations. 

Private Funding 

For those with the resources to do so, private pay is always an option. If the client only needs care for a few hours a week, this may be much more doable than for those who need full-time care. For example, those using Senior Home Care services 20 hours a week can expect to pay an average of $1,950 a month for personal care assistance and $1,993 a month for home health care, according to Genworth Financial. 

However, if the client needs more regular care, the cost can become prohibitive. At the 42 hours a week mark, Senior Home Care becomes more expensive than assisted living, at $4,095 a month and $4,051 a month, respectively. Around-the-clock Senior Home Care costs an average of $16,380 a month for personal care assistance and $16,743 for home health care. Thus, if the client needs around-the-clock care, it may make more sense financially to move to a residential care home. 

If moving is not an option and you’ve exhausted your financial resources, try talking to several different Senior Home Care providers in your area. The costs listed above are the national average, so costs in your area can vary.