Paying for Personal services

Personal Funds
At first, many people pay for long-term care services with their own money. They may use personal savings, a pension or other retirement fund, income from stocks and bonds, or proceeds from the sale of a home.

Medicare and Medicaid
Contrary to what many people think, Medicare does not cover most long-term care costs. It does not cover ongoing personal care at home, like help with bathing.

Medicaid Coverage is Broader
To be eligible, you must meet certain financial and health requirements. People with financial resources above a certain limit will most likely not qualify unless they first use up their own resources to pay for care, which is called "spending down." Who is eligible and what services are covered vary from state to state. (For more information about Medicaid coverage, see

Veterans' Benefits
Veterans' benefits are another source of government funds, and they may help veterans with disabilities and their spouses pay for personal care and homemaker services provided at home. Disabled or aging veterans with long-term care needs may be able to get help from the U.S. Department of Veterans Affairs (VA). Call 800-222-8387 for more information or visit

Older Americans Act Programs
The Older Americans Act is a Federal program designed to organize, coordinate, and provide home- and community-based services to older adults and their families. A broad array of programs helps older adults’ remains in the community as independently as possible.
Services under the Older Americans Act are provided by state and local agencies and other organizations. They include in-home personal care and homemaker services for frail older adults, meals in the community and for homebound elderly, local transportation services, respite care, and services for older Native Americans.

You do not have to have a certain income to use these programs, but they are targeted at low-income, frail, or disabled seniors over age 60; minority older adults; and older adults living in rural areas. For more information, see
New Hampshire Home and Community Care

Mary Gail Grant

  • To qualify, women must live alone, or with another woman, and be indigent, defined at 200% of the poverty level.
  • Woman who are experiencing difficulties staying in their own homes and need of assistance with medication management, meals or any activity of daily living.

Eligibility for the program is limited to women who live in Manchester, Auburn, Bedford, Candia, Hooksett, Goffstown, Litchfield or Londonderry Call the VNA Intake Nurse at 622-3781

Long-Term Care Insurance
The exact coverage depends on the type of policy you buy and what services are covered. You can purchase a comprehensive policy that includes both home care and facility care. Many companies sell long-term care insurance. It is a good idea to shop around and compare policies.

Reverse Mortgages
A reverse mortgage is a special type of home loan that lets a homeowner convert part of the ownership value in his or her home into cash. Unlike a traditional home loan, no repayment is required until the borrower sells the home, no longer uses it as a main residence, or dies.
There are no income or medical requirements to get a reverse mortgage. The loan amount is tax-free and can be used for any expense, including long-term care. If long-term care costs are higher than the amount you borrow, selling your home is not required, but doing so may provide enough funds to repay the loan.

Life Settlements
Policies with an "accelerated death benefit" provide cash advances while you are still alive. You can get an accelerated death benefit if you live permanently in a nursing home, need long-term care for an extended time, are terminally ill, or have a life-threatening diagnosis. Check your life insurance policy to see exactly what it covers.

You may be able to raise cash by selling your life insurance policy for its current value. This option, known as a "life settlement," is usually available only to people age 70 and older. The proceeds are taxable and can be used for any reason, including paying for long-term care.
A similar arrangement, called a "viatical settlement," allows a terminally ill person to sell his or her life insurance policy to an insurance company. This option is typically used by people who are expected to live 2 years or less. A viatical settlement provides immediate cash, but it can be hard to get.

For more information about paying for long-term care, see the Web site of the National Clearinghouse for Long-Term Care Information,