Paying for care is hard.
Knowing your options helps.

Medicare is federal health insurance for people 65 and older. It covers medical care — not day-to-day help at home.

• ✅ Covered: Doctor visits and hospital stays
• ✅ Covered: Skilled nursing care ordered by a doctor
• ✅ Covered: Physical, speech, or occupational therapy at home
• ✅ Covered: Prescription drugs (Part D)
• ❌ Not covered: Bathing, dressing, or cooking help
• ❌ Not covered: 24-hour home care
• ❌ Not covered: Long-term nursing home stays
• ❌ Not covered: Meal delivery or companion care

After a hospital stay, Medicare may cover up to 100 days in a skilled nursing facility — but rules apply and it does not last forever.

Medicaid is a joint state and federal program for people with low income and limited assets. Unlike Medicare, Medicaid does cover long-term care — including nursing homes and in-home personal care.

To qualify, your parent generally must have:

• Limited monthly income (varies by state)
• Limited assets — usually under $2,000 in countable assets
• A demonstrated need for care

Many middle-class families fall into a gap — their parent earns too much for Medicaid but not enough to comfortably pay for care. This is one of the hardest financial situations in caregiving.

Rules vary a lot by state. Contact your local Area Agency on Aging or an elder law attorney to find out what your parent qualifies for.

A Medicare Advantage plan (Part C) is an alternative to original Medicare. These plans are offered by private insurance companies and must cover everything original Medicare covers — but many offer extra benefits like dental, vision, and hearing.

Some Medicare Advantage plans also cover limited home care, meal delivery, or transportation — things original Medicare does not cover. It is worth checking what your parent’s specific plan includes.

The downside: you are often limited to a network of doctors and may need referrals. Compare plans carefully before switching.

Original Medicare does not cover 100% of medical costs. A Medigap plan is supplemental insurance that helps pay the gaps — like co-pays, deductibles, and costs for care outside the US.

Medigap plans are sold by private insurance companies and are labeled by letter (Plan G, Plan N, etc.). They do not cover long-term care, dental, or vision.

If your parent has both Medicare and a Medigap plan, their out-of-pocket medical costs will likely be much lower. Check what plan they have and what it covers.

Long-term care insurance is a policy that pays for care when a person can no longer handle daily tasks on their own — bathing, dressing, eating, or getting around.

If your parent has a policy, now is the time to use it. Many families forget a policy exists until it is too late to file a claim. Here is what to do:

• Find the policy documents — check files, safe deposit boxes, or with an insurance agent
• Read the “benefit triggers” — most policies pay when your parent needs help with 2 or more daily activities
• Call the insurance company and ask how to start a claim
• There is usually an “elimination period” — a waiting period before benefits start, often 90 days

Note: Long-term care insurance is no longer available in many states. If your parent does not have a policy, this option may not be available to them.

Yes — in some situations. Here are the main ways this can happen:

• Medicaid waiver programs: Many states have programs that allow family members to be paid as caregivers. Contact your state’s Medicaid office or Area Agency on Aging to find out what is available in your state.
• Veterans benefits: If your parent is a veteran, the VA’s Aid and Attendance program can provide money for care — and a family member can sometimes be the paid caregiver.
• Personal care agreements: A formal written contract between a parent and adult child that pays the child for caregiving services. This must be done properly to avoid Medicaid complications — consult an elder law attorney.
• Long-term care insurance: Some policies allow payments to family caregivers. Check the policy details.

The VA Aid and Attendance pension is one of the most underused benefits available to veterans and their families. If your parent served in the military, they may qualify for significant monthly financial help to pay for care.

To qualify, your parent must:

• Have served at least 90 days of active duty, with at least one day during wartime
• Need help with daily activities like bathing, dressing, or eating
• Meet income and asset requirements

In 2025, the benefit can pay up to $2,300 per month for a veteran, and up to $1,478 per month for a surviving spouse. This is not widely advertised — many eligible families never claim it.

Contact your local VA office or a Veterans Service Organization (VSO) for free help applying. Never pay a company to help you apply — this service is always free.

Every state has programs to help seniors stay at home and get care — but they vary a lot and are not well advertised. Here is how to find what is available:

• Area Agency on Aging: Every region has one. They know every local and state program available. Call 1-800-677-1116 to find yours — it is free.
• Medicaid waiver programs: Many states offer home and community-based services that pay for in-home care for people who qualify.
• PACE programs: Program of All-inclusive Care for the Elderly — provides medical and social services to help seniors stay at home instead of going to a nursing facility.
• State pharmaceutical assistance: Many states help low-income seniors pay for prescriptions that Medicare Part D does not fully cover.

The best one phone call you can make: call your local Area Agency on Aging. They will tell you every program your parent qualifies for — at no cost to you.

A reverse mortgage lets a homeowner aged 62 or older borrow against the value of their home. They receive money — as a lump sum, monthly payments, or a line of credit — and do not have to repay it as long as they live in the home.

The loan is repaid when the homeowner moves out, sells the home, or dies.

When it might make sense:

• Your parent owns their home outright or has significant equity
• They plan to stay in the home long-term
• They need money to pay for in-home care
• They have no heirs who want to inherit the home

When to be careful:

• Fees and interest can eat into the home’s value quickly
• If your parent moves to a nursing home for more than 12 months, the loan may come due
• It can affect Medicaid eligibility

Always get independent financial advice before going this route. A HUD-approved housing counselor can walk you through the pros and cons for free — call 1-800-569-4287.

Older adults are the most targeted group for financial scams. Here are the most important steps to take:

• Set up account alerts at their bank — you get a text or email when money moves
• Review bank and credit card statements monthly
• Talk to them about common scams — Medicare fraud calls, fake grandchild emergencies, IRS impersonators
• Remind them: a real government agency will never call and ask for a gift card or wire transfer
• Consider setting up a trusted contact at their bank — someone the bank can call if they notice suspicious activity
• If you suspect financial abuse, contact Adult Protective Services in your state

Money is personal. Many parents resist talking about it — especially with their adult children. Here are some ways to open the door:

• Start with your own situation: “I’ve been thinking about my own finances and it made me wonder if we should talk about yours.”
• Frame it as protection, not control: “I just want to make sure you’re protected if anything ever happens.”
• Ask about documents, not amounts: “Do you have a will? Do you know where everything is?”
• Bring in a neutral third party — a financial advisor or elder law attorney can sometimes say things that land better coming from a professional
• Pick a calm moment — not during a health crisis or family conflict

You may not get all the answers in one conversation. That is OK. Opening the door is what matters.