"Understanding Your Care Options: Private Pay, Long-Term Care Insurance, and Veterans Benefits"

One of the biggest questions families face when considering in-home care is: how do we pay for this? The good news is that several options exist. Understanding them can help you plan effectively and access benefits you may not have known were available.

Geriatric Care Solutions accepts three primary payment sources: private pay, long-term care insurance, and veterans benefits. Here's what you need to know about each.

What Medicare Does NOT Cover

Before discussing what does pay for care, it's important to clarify a common misconception: Medicare does not cover custodial care.

Medicare covers skilled medical care — things like skilled nursing visits, physical therapy, and medical equipment after a hospitalization. But it does not cover the ongoing, non-medical help most seniors need: assistance with bathing, dressing, meals, medication reminders, companionship, and supervision.

This type of care — custodial or personal care — is what families typically need most, and it requires other funding sources.

Option 1: Private Pay

Private pay simply means paying for care out-of-pocket using your family's own resources. This is the most straightforward option and the one most families start with.

Sources for private pay include regular income, savings and retirement accounts, proceeds from selling a home, family contributions pooled together, and reverse mortgage funds.

Private pay advantages: complete flexibility in choosing care hours and services, no approval process or paperwork delays, ability to start immediately, and no restrictions on how care is used.

When considering private pay, it helps to project costs realistically. How many hours of care are needed weekly? What's the cost per hour in your area? How long might care be needed? Understanding these numbers helps families plan and prevents financial surprises.

Option 2: Long-Term Care Insurance (LTCI)

Long-term care insurance is a policy specifically designed to cover the costs of extended care, including in-home care. If your loved one purchased this insurance years ago, it may now provide significant benefits.

How it works: After meeting the policy's benefit trigger (typically needing help with two or more activities of daily living, or having cognitive impairment), the policy pays a daily or monthly benefit toward care costs. There's usually an elimination period (waiting period) of 30-90 days before benefits begin.

Using LTCI requires understanding your policy's specific terms including what triggers benefits, how much the daily/monthly benefit is, how long benefits last (some policies have lifetime limits), whether benefits are adjusted for inflation, what documentation the insurer requires, and whether there's a waiting period before benefits begin.

Geriatric Care Solutions can help you navigate LTCI claims and ensure care documentation meets your insurer's requirements.

If you have an LTCI policy, use it. Many families pay premiums for years and then don't file claims when they're eligible, leaving significant benefits unused.

Option 3: Veterans Benefits

Veterans and their surviving spouses may qualify for benefits that help pay for in-home care. The primary program is Aid and Attendance, a pension benefit for wartime veterans or surviving spouses who need help with daily activities.

Basic eligibility requirements include wartime service during qualifying periods (WWII, Korean War, Vietnam, Gulf War era, etc.), discharge under other than dishonorable conditions, limited income and assets (with specific thresholds), and medical need for assistance with daily activities or regular supervision.

Aid and Attendance can provide meaningful monthly benefits toward care costs. The exact amount depends on veteran status, dependency status, and other factors.

The application process can be complex. Many families benefit from working with an accredited VA claims agent or attorney. Be cautious of companies that charge excessive fees for assistance.

Geriatric Care Solutions can provide documentation of care services that supports VA benefit claims.

Combining Payment Sources

Many families use multiple sources to fund care. For example, they might use long-term care insurance as the primary funding, supplemented with private pay for hours beyond what the policy covers.

Or they might use veterans benefits to partially offset costs while paying the remainder privately.

Understanding all available options helps you maximize resources and sustain care longer.

Planning Ahead

If your loved one doesn't currently need care but may in the future, now is the time to understand their resources and options. Review any long-term care insurance policies to understand benefits. Gather military service records if veteran status applies. Have honest conversations about financial resources. Consider consulting with an elder law attorney or financial planner who specializes in senior care.

Your Next Step

Understanding how to pay for care is essential for planning. If you have questions about using insurance or veterans benefits with our services, we're happy to help you explore your options.

Geriatric Care Solutions accepts private pay, long-term care insurance, and veterans benefits. Let us help you understand your options and plan for sustainable care. Call 1-888-896-8275 or email ask@gcaresolution.com.