Managing Costs for Day Programs for the Elderly and Disabled Younger Adults
Summary
An adult day program is a type of long-term care program you go to during the day. Program costs vary, but most aren’t covered by health insurance. This article will tell you some ways to manage costs for day programs for the elderly and disabled younger adults. This article doesn’t provide legal or financial advice.
Private Options
Private health insurance usually won’t cover day programs for disabled adults or the elderly. However, if you have long-term care insurance, that could help. Other private ways to pay include annuities, trusts or life insurance cash-outs. Before choosing any of these options, consult a trusted financial advisor.
Government Coverage for Elderly and/or Disabled Day Programs
Original Medicare won’t cover elderly day programs. But if you have Medicare Advantage, it might pay for some day program services. The Program of All-Inclusive Care for the Elderly (PACE) and the Older Americans Act may help too. And, if you’re a veteran, the Department of Veterans Affairs may cover adult day care. Medicaid will often pay for community-based services for the disabled and the elderly. If you’re disabled, you might be able to get Social Security benefits to help pay for adult day programs. Also, students with disabilities can get free public schooling until they’re 21 years old.
Other Ways to Save
Some groups, such as the Alzheimer’s Association or the Autism Society, may be able to offer financial help for day programs. You can also ask the day program whether it offers a sliding scale for payment. And you may be able to deduct day program payments you make when you file your taxes.
Private Options
Private health plans. Private health insurance usually won’t cover day programs for disabled adults or the elderly. Sometimes it covers skilled, medically necessary care, but only for a short time, so check with your insurance plan. Disability insurance won’t cover adult day programs at all. However, if you have long-term care insurance, that could help.
The costs of long-term care insurance depend on certain things. Some of these are the type of policy, the number of services and how old you are when you buy it. Some plans won’t pay for social programs, only healthcare programs. Also, if you already need care services, you may not qualify, or costs may be higher for long-term care insurance. Find out more at longtermcare.gov.
Private payment. Many older adults use their savings, retirement funds or money from family to pay for day programs. The same is true for families of disabled adults. Other private ways to pay include:
- Annuities. This is a contract between you and an insurance company. You pay the company a lump sum or a series of payments and it gives you future regular payments for a fixed amount of time, or sometimes for the rest of your life.
- Trusts. A trust is like an account that is managed by one person or an organization, where money or property is kept for the benefit of another person. You can set up a trust for an elderly person or a younger adult with a disability.
- Life insurance cash-out. If you have a life insurance policy, you can sometimes take money out of it early.
Before choosing any of these options, consult a trusted financial advisor. The advisor can help make sure your decisions make sound financial sense. The advisor can also help explain the risks involved in each option. The Consumer Financial Protection Bureau can help you find fair financial information and avoid scams. In addition, consult a tax professional to find out how the above private payment options affect your taxes, and an attorney to address any questions related to trusts or other legal topics.
Government Coverage for Disabled Younger Adult Day Programs
Medicaid. Medicaid will often pay for home and community-based services for disabled people, which can include adult day programs:
- Intermediate care facilities for people with intellectual disabilities (ICF/ID) are a benefit typically offered by Medicaid. You can only get ICF/ID if you’re getting “active treatment services.” This means care or medicine that you need regularly over a long period of time. In other words, ICF/ID is for disabled people who need a lot of help every day. Your disability must also have started before age 22. Find out more here.
- States also offer their own Medicaid waivers that can cover services. There are waivers just for people with disabilities who may not meet all the normal requirements for Medicaid.
Social Security benefits. You might be able to get Social Security benefits if you’ve worked enough or have low income. This could help pay for adult day programs. Check out our article on Benefits for People with Disabilities for more details.
Public school. Students with disabilities can get free public schooling until they’re 21 years old. This is per the Individuals with Disabilities Education Act (IDEA).
Your Action Plan: How to Pay for Adult Day Programs
- Think about taking out long-term care insurance or look into private pay options.
- If you’re looking for elderly day care, find out if you qualify for Medicaid, Medicare Advantage or PACE.
- If you’re a veteran, be sure to find out if you can get VA coverage.
- If you’re looking for disabled adult day programs, find out if you qualify for Medicaid programs and Social Security benefits.
- Consider keeping your adult disabled child in free public school until he or she is 21.
- If you or a loved one have a specific disease or disability, look into organizations that support those affected.
- Don’t be afraid to ask a day program if it has a sliding scale for payment.
- Remember: You may be able to deduct day program payments you make when you file your taxes.