Medicare, Medicaid, and tax credits exist specifically for families like yours. Most people never claim what they are owed. Here is everything you need to know.
They sound similar but they work very differently. Knowing which one applies to your situation is the first step to getting help.
Federal health insurance for people 65 and older or those with qualifying disabilities.
Medicare covers skilled home health visits ordered by a doctor, such as a nurse or therapist visiting after a surgery, hospital stay, or illness. Coverage is limited to part-time medical care, not ongoing daily personal care.
Note: Medicare does not cover ongoing personal care like bathing or companionship if that is the only service needed.
Income-based government coverage for long-term personal care at home.
Medicaid is the bigger opportunity for most families. Through Consumer Directed Care, Medicaid can pay a caregiver of your choosing including a family member, friend, or private CNA. The state assigns a care budget based on your loved one's needs.
It depends entirely on the needs assessment. A state caseworker evaluates your loved one's level of care need and assigns a weekly budget of hours accordingly.
| Level of Need | Hours per Week |
|---|---|
| Light assistance | 10 to 20 hours |
| Moderate needs | 20 to 40 hours |
| High needs | 40 or more hours |
Medicaid rarely covers 24-hour care but it can cover a significant portion of your costs. Combined with private pay through AtMyMoms for remaining hours, most families see total costs drop dramatically.
Medicaid is income-based. Your loved one must be low income and either 65 or older, or disabled. Each state has its own income and asset limits. In Oklahoma the program is called ADvantage Waiver.
Apply at your state Medicaid office or Benefits.gov. Once approved, request a home and community-based waiver assessment. A caseworker visits the home and evaluates care needs.
Once approved, you choose your caregiver. Through Consumer Directed Care, that person can even be a family member. Your caregiver enrolls as a provider and gets paid directly from the state budget.
Caring for a loved one at home may entitle you to significant tax savings. Most families never claim these.
If your loved one qualifies as your dependent and does not qualify for the child tax credit you may claim this.
For working caregivers who pay for someone to care for a loved one while they work.
Qualifying medical expenses that exceed 7.5% of your adjusted gross income can be itemized.
If your loved one lives with you and you pay more than half of household expenses you may qualify.
I personally recommend PNL Financials, a CPA firm with a strong history of helping families in exactly this situation. I have no financial arrangement with them. I recommend them because they helped my own family and they know this space. Email me and I will connect you with a discounted or even free initial consultation.
Email me with your loved one's situation and I will personally look at your options at no cost. Subject line: Help With Care Coverage.
williammongou@atmymoms.com