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Posted: July 26, 2004

Practical Caregiving

Research and Request to Get Benefits You Deserve

I received a couple questions recently regarding what the government will or will not pay for regarding caregiving and eldercare. After talking with various people in different government offices, I am rounding up the information here for all caregivers to hopefully benefit. I also checked about long-term care insurance and thought my readers might be interested in that information. There are also a couple other organizations you might want to check into for help.Here are questions that got me thinking on these points:

Dear Jean:

I was searching the web for resources and came across your page. I will be taking care of my grandmother in my home and need to remodel to provide easy access for her. This is quite expensive.

Are there any programs that offer loans for this type of activity? I'm trying to figure out how to pay for all the expenses I will have for the remodeling and hiring someone to be with her in the daytime while I work.

Kim B., Hudson, Florida

Dear Jean:

I have been taking care of my grandfather for a year. While I do not live with him (yet), I am there all day, do his laundry, house clean, make meals, and give him medicine.

My question is, whether Medicare will pay me for my services? If so, how do I begin the process? Thank you in advance,

J F., Los Angeles


You both are doing such a wonderful thing in taking care of your grandparents in your homes. It is frustrating, and there are expenses you can?t foresee, but you will always be glad you kept them there. There may come a time when you have to put them in a nursing home, but when that time comes you will know that you did everything you could to take care of them.

When you call anyone regarding services available to you, always ask if they know of anything else you might want to check into. One person I know was able to get free accounting assistance for their loved one because they simply asked the question. Remember: talking with one person can lead to another who can help!

You both should check with your local Administration on Aging (AoA) and ask about the National Family Caregiver Support Program (NFCSP). This is a federal program but it is administered by individual states. The state determines how it is administered, and the guidelines vary from state to state. Those eligible include family caregivers of older adults (age 60+), grandparents (age 60+) and relative caregivers (age 60+) of children not more than 18 years old. In other words, while you need to talk to the office in your state to find out what services are available to you, these age brackets and duty descriptions should be helpful to you. Be sure to ask for the Family Caregiver Specialist because not everyone understands the program.

There are guidelines for this program but each state decides how to implement them. The guidelines call for the states to provide:

1. Information to caregivers about available services.

2. Assistance for the caregiver in gaining access to supportive services.

3. Counseling and training to assist the caregiver in making decisions and solving problems related to their caregiver roles.

4. Respite care to temporarily relieve the caregiver from their responsibilities.

5. Supplemental services on a limited basis, to complement the care provided by caregivers.

To find the offices in your state, call toll-free 1-800-677-1116, Monday through Friday, 9:00 am to 8:00 pm Eastern Time. If you want to read more about this program, go to: This URL will link you to the Older American Act Official Compilation at

Some states offer low interest rate loans for home modification to accommodate the limitations of your loved ones. They will probably know where to refer you to, so ask them about that. You may have to make a few phone calls to get to the right person, but you won?t get the help if you don?t make the calls.

Also, run your loved one?s information through the following website. It is a free site set up by the government, and you may find something your elderly qualifies for that they don?t know about. You don?t identify them, either. The website address is:

I called Medicare and was told that they do not pay family members to take care of their loved ones. Check with the above programs because I have also heard that it may be possible for the caregiver (as long as it is not a spouse) to get assistance, but I don?t know if that it true or not. (Let me know by email, if you find out.)

Now, to long-term care insurance. If your loved one has long-term care insurance, you should ask what it covers and specifically whether it covers necessary home modifications due to your loved one?s limitations. The following list covers a few things you might want to know about long-term care insurance.

1. Ask for the outline of coverage or a specimen policy. This gives all the details.

2. What is the daily coverage and is there an inflation rider? The inflation rider will increase the daily coverage as inflation goes up.

3. Is there a pool of money or does the policy provide coverage for a specified period of time?

a. The pool of money means there is a maximum amount of money the policy will pay. Everything paid comes out of that pool. When it is gone, it?s gone.

b. If the benefit is for a specified period of time, benefits cease after that time period expires.

4. What is the elimination period? The elimination period is similar to a deductible in a health insurance policy. It is the period of time you must pay the costs before the insurance policy will pay anything. It can be any length of time but is commonly up to 180 days.

5. What is the waiver of premium period? In other words, after you start receiving benefits, how long do you need to keep paying the premium to keep the policy?

6. There are two ways policies pay:

a. Reimbursement. In this one, you pay the bill and the insurance company reimburses you up to the amount of your daily benefit covered by the policy. For example, if your loved one is in a nursing home and the policy will pay up to $200 a day but the nursing home charge is only $150 a day, then the policy will pay the $150 a day.

b. Indemnity. The insurance company will pay a person with the power of attorney the total amount of daily coverage offered by the policy, regardless of the actual charge. If there is any extra benefit, it can be used in any way. For example, if your loved one is in a nursing home with a policy that will pay $200 a day, then the policy will pay the $200 a day even if the charge is only $150 a day.

7. Some insurance policies will pay for modification of homes to accommodate your loved ones limitations. The "Alternate Plan of Care" and "Stay at Home Benefit" are two terms used in policies that offer this provision. Most policies sold today include this type of coverage. Five or 10 years ago, most did not.

Good luck. This may all sound complicated (and certainly some of it is), but it is important to research and request ? to obtain what you can.

© 2004 Pederson Publishing, Inc. All Rights Reserved.
Commercial use, redistribution or other forms of reuse of this information is strictly prohibited without the prior written permission of Pederson Publishing.

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