Caring for an aging loved one takes an enormous emotional and financial commitment. Alzheimer's disease is a progressive brain condition that impairs cognition and causes memory loss. It affects 5 million Americans over the age of 65. A diagnosis can mean years of paying for medical visits, Alzheimer's care at home, or even long-term care at a memory care facility. The costs add up quickly - the annual cost of Alzheimer's disease is $259 billion. So, how can you pay for quality care without facing bankruptcy?
According to the National Institute on Aging, insurance companies may cover treatment for Alzheimer's disease when it is diagnosed by a doctor and meets specific requirements. Each insurance policy has different requirements, and coverage may vary state-to-state. Knowing which type of coverage a care recipient has will help provide more comprehensive care for their illness.
While the disease may progress slowly, sometimes, the patient may not be able to care for themselves. Long-term care may be needed, sometimes at an Alzheimer's care facility. If a family member cannot take care of their hygiene, for example, or basics like safely preparing dinner or dressing, they may need 24-hour care.
Medicare does not differentiate Alzheimer's, dementia, and memory care from other conditions like heart disease. Instead, Medicare has specific policies concerning when and how much it will pay for particular types of care. Medicare does not cover personal care services but does cover medical care, and its nursing home benefits are limited to 100 days. The exception to this is for people who receive at-home hospice care; Medicare will pay for personal care for people who are determined to be in the final six months of their life.
Medigap plans, or Medicare Supplementary Insurance, do not expressly provide additional benefits for Alzheimer's patients but offer supplemental assistance.
Medicaid is a state and federally-funded health insurance program for low-income families. Each state manages its Medicaid programs separately, offering different benefits regarding Alzheimer's, dementia, or memory care.
Almost all Medicaid Waivers require financial eligibility, and the participant has functional limitations. Very few Medicaid Waivers require a specific diagnosis of Alzheimer's or dementia. Still instead, they are based on a person's capacity to care for themselves by assessing their ability to perform activities of daily living. From this functional standpoint, mid to late-stage Alzheimer's patients often qualify for Medicaid benefits easily.
Medicaid will typically cover a portion of assisted living and nursing home expenditures for people with dementia. The program offsets some costs of medical appointments, inpatient hospital care, and prescription drugs. If the care recipient has not applied to Medicaid, have them meet with a social worker to discuss the application process. Medicaid can help low-income seniors get the care they need.
Various state-funded or state-controlled help programs are available to lower-income people who need aid with everyday activities. Even though these programs weren't explicitly made for Alzheimer's patients, they often qualify since many don't work, have low incomes, and need daily help. View a complete list of non-Medicaid state assistance programs from Paying For Senior Care.
Aside from the more general assistance programs, some states have programs designed for individuals with dementia or Alzheimer's. These programs don't base eligibility on an individual's financial income or assets, requiring only a valid diagnosis of Alzheimer's or dementia.
Even though the VA doesn't have programs specifically for people with Alzheimer's or dementia, there are still certain benefits that veterans with those conditions could take advantage of through other VA programs. Aid and Attendance is a pension benefit that can provide financial assistance—up to approximately $2,230 per month in some cases. VA Respite Care and Veterans' Directed Home and Community Based Services may assist.
Tax credits such as the Credit for the Elderly or the Disabled can be a bonus for an adult child taking care of a parent with dementia, provided the credit covers at least half of the financial assistance required. In addition to the federal credit, some states also offer credits to help reduce taxes payable.
These loans may be a solution for people needing short-term senior care financing. They are best used when a family is waiting on additional financing. For example, a family may know they need to wait nine months for veteran's benefits or plan to pay for Alzheimer's care with the proceeds of a home sale.
With so many ongoing costs for quality treatment, family caregivers and seniors may want to take advantage of job benefits. What benefits provided by employers help with dementia care? Some jobs offer family caregiving leave that is both paid and unpaid, especially for federal and state government positions. Not all companies provide family leave options. However, speaking with your employer about your family's needs may provide opportunities you can take advantage of, like unpaid time off or using vacation days for sick leave.
Suppose the person with Alzheimer's still works during the early stages of the disease. In that case, they may still have access to employee benefits like paid sick leave, short-term disability benefits, or a flexible spending account.
While most daily costs are covered by insurance, long-term care often is not. Most individuals staying at assisted living facilities have to pay via their private funds. There are several ways to cover Alzheimer's treatment:
Seniors should speak with their families and financial advisor about planning for long-term care if they can. Family caregivers can review the available finances to aid in planning. It may be possible that assets from selling a home, real estate, or vehicles can offset costs for nursing home care or Alzheimer's care at home.
Many pharmaceutical companies offer assistance programs for individuals that need a prescription but can't pay for it. These assistance programs can provide medications free of charge, or if a person has insurance, the pharmaceutical company may waive the co-pay cost. You can search this database to find financial assistance for Alzheimer's medications.
It can be challenging to choose the ideal senior living community for Alzheimer's patients. Somewhat independent patients can receive complete care at assisted living facilities, and Medicaid and Medicare only sporadically cover assisted living. Facilities in nursing homes are preferable for individuals with advanced illnesses who cannot live independently.
Assisted Living Communities have more amenities and services than a nursing home. These communities help with activities of daily living like meal preparation and shopping, laundry, and bathing assistance. If a patient only needs minimal help and has not progressed to the advanced stages of dementia, an assisted living community may offer a safe alternative to living alone.
Skilled Nursing Facilities provide around-the-clock professional care for elderly patients with serious illnesses or injuries who need 24-hour supervision. Patients may require full-time nursing care or intermittent assistance during specific hours of the day. Skilled nursing facilities may include some of the same amenities as assisted living facilities, like social activities, a communal dining hall, and private rooms.
Some Alzheimer's patients may choose to live at home if they can live somewhat independently and do not require 24-hour care. Family caregivers or home health aides may help them with daily tasks like buying groceries or helping with the family pet. Sometimes just companionship helps.
Often available for free or at a heavy discount, respite care is short-term aid that gives the primary caretaker of an Alzheimer's patient a break. This support can happen at home, an adult day care center, an assisted living residence, or other residential areas.
Search the following resources to find respite services available in your community:
Some federally funded programs provide free or reduced-rate respite care, like Lifespan Respite Care and the National Family Caregiver Support Program.
A diagnosis of Alzheimer's can have a considerable emotional and financial cost. However, a patient can have a much better prognosis and quality of life with quality caregiving. Finding how to pay for Alzheimer's care can be daunting, and spending time planning to care for the care recipient financially as they journey through this illness.
