Paying for In-Home Care


Older Woman With Doctor




It is  hard to acknowledge that an older family member is beginning to need additional care. However, when a family can have those discussions and decide to ask for assistance, everyone's burden is eased.

There are a variety of services available. Some are in-home and some are offered in other locations such as Senior Centers or churches.

Some services are available for free to anyone who is a senior (typically 60+) and/or their caregiver, some ask for voluntary contributions, some are sliding-fee, and some are fee based. It is important as you coordinate services that you find out the eligibility requirements of the service and the cost.

Information and Assistance Specialists at your local Council or Department on Aging can help you determine what services are available in your county, whether you will be able to access them, and what type of fee, if any, is required.


Most of the services offered through Councils or Departments on Aging are paid for with Home and Community Care Block Grant funds that come from the federally funded Older American's Act. These services are offered to seniors (60+) and their caregivers on a cost-sharing (voluntary contribution) basis. Since funds for the services are limited, it is asked that you contribute as much as you are able so that more people can make use of the service.


To find out what services are available, try the following:


Every state and county will be different. And, there are a lot of groups that offer volunteer assistance to help fulfill needs such as friendly visiting, building wheelchair ramps, yard work, and household repairs and home modification. There are also services available to help those who are hearing disabled, have vision loss, or have other disabilities. It is always a good idea to check with your local aging agency. It is their job to know what is available locally to help you. And, they are glad to help. Remember, local aging agencies are designed to work with older adults and their caregivers. They can help with finding services, even those not offered by their agency, and with accessing the services. If you like, they will also follow-up with you to ensure that you got the services you needed and that you were satisfied with the assistance.




Departments of Social Services

There are special services to help low-income individuals who need services but cannot afford to pay for them. Local Departments of Social Services (or Human Services Agency) and/or local Councils or Departments on Aging have detailed knowledge about what is available and how to qualify for assistance. Check with your local agency to see what programs are available in your area.


Call Your Local
Department of Social Services
if You Need Help
Person Available to Help





Health Departments

Your county should have a Health Department. If you have a health need, check with your local Health Department.

Person Available to Help


They are involved in areas such as disease and epidemic prevention, promoting healthy lifestyles, nutrition, immunizations, and basic health care for those who have no other options.


To find the one that serves you , contact your local Area Agency on Aging or the Eldercare Locator service.




Departments Helping the Disabled

Woman in Wheelchair with Companion State governments usually have specific Departments that assist the disabled such as "services for the blind and visually impaired" or "services for the deaf and hard of hearing". Those Departments often offer financial assistance for qualified individuals to help pay for assistive technology and other needs related to a disability. Be sure to check.





Reverse Mortgages

Reverse mortgages enable homeowners who are 62 years of age or older to convert a portion of the equity in their home into cash. Typically, reverse mortgages are used by individuals who have paid off their mortgage or are close to paying it off. Their money is "tied up" in their home.

Reverse mortgages may provide a monthly income and/or a line of credit. There are no restrictions on the use of the money and since a reverse mortgage is a form of a loan, the homeowner retains ownership of the property. The loan is not repaid until the homeowner permanently leaves the home.

There are caveats with reverse mortgages so consult with your banker, attorney, and/or agencies who counsel homeowners on this type of resource.

Reverse Mortgage Counselors are available in some areas. They have had training related to the issues surrounding reverse mortgages and how to help you make appropriate choices. Information & Assistance Specialists can help you find a Reverse Mortgage Counselor. Some of the counselors are HUD approved.


NCAdditional Information for NC Residents


Attorneys may or may not have expertise in this area. Be sure to ask before scheduling an appointment should you decide that you want legal advice. Should you feel that you cannot afford an attorney, contact your local Bar Association for a referral to an attorney who may be able to assist you at no cost.




Home Equity Loan

A Home Equity loan provides a homeowner with substantial equity in their home the opportunity to convert that equity into cash. It is a loan that you must apply for with your bank and you will be required to make monthly repayments. Carefully consider whether you will be able to repay the bank on time because if you cannot, they can repossess your home.

That is the principal difference between home equity loans and reverse mortgages:

  • with a reverse mortgage payment is due only when the homeowner permanently leaves the home
  • but with a home equity loan, repayment is due monthly.

Consult with your attorney, accountant, and/or banker before making this decision.


Should you feel that you cannot afford to have a professional help you, contact your local Bar Association for a referral to an attorney who may be able to assist you at no cost.




Tax Credits

If you claim your family member as a dependent for tax purposes, you may be eligible for medical expense deductions and dependent care credits. There may be other tax credits available for those who are 65 years of age or older and/or those who are disabled. For more information on tax issues, contact your accountant, or the Internal Revenue Service (IRS) (1-800-829-1040).

The Internal Revenue Service sponsors free volunteer assistance programs and offers help to taxpayers in many of its offices and other community locations. These volunteers have been trained by federal and state tax officials.


Another program, Tax Counseling for the Elderly (or TCE), is designed primarily for persons 60 years or older, particularly those who are confined to their residences or retirement communities. IRS–trained volunteers from non–profit organizations provide free tax counseling and basic income tax return preparation to senior citizens. Volunteers travel to taxpayers' homes, if they are unable to come to a local TCE site.

Under a cooperative agreement with the IRS as part of this program, AARP has operated a Tax-Aide program since 1968. The program is available February 1 - April 15 but, during the off-season, the program continues to provide on-line tax counseling.


You can get free telephone assistance from the IRS by calling 1–800–829–1040. This number now is manned by a live person(s). Ask about local IRS offices you may visit to receive assistance.



Tax Information Phone Numbers and Websites

IRS - live person
File Electronically
Online Help
Tele-Tax - recorded topics
Tax Forms and Publications
Refunds - recorded
Hearing Impaired
National Taxpayer Advocate





Retirement Benefits

If your older family member worked, he or she may have retirement benefits. These could be company retirement plans or a number of different individual retirement accounts (IRAs). Your prior financial planning could have also included annuities, personal savings accounts, investments, and real property (land, home, etc.). If you have not already done so, explore whether or not these types of benefits are available to you and when and how you can access them.




Social Security - Medicare & Medicaid

The section, Paying for Long-Term Care, will offer you many resources to help you determine what federal benefits may be available to you. It is possible that you and your family member may be eligible for benefits that you don't know about. These benefits may pay all or a part of the cost of in-home services. This is especially true if your family member has become disabled. Medicare now has an online brochure detailing coverage for Home Health Care and a service that helps you compare Medicaid certified agencies providing home health services.

Social Security Card




Credit Counseling

If you are having trouble with creditors and need help, consider contacting a consumer credit counseling service. They will help you to consolidate your bills, if appropriate and necessary, and will help you to work with your creditors on repayment.

To follow are links to free credit counseling services. Listing these sites and offering links to them does not constitute endorsement. Each consumer should read the information about the company and decide whether to use them or not.





Sometimes the financial issues surrounding caregiving are so great that a retired spouse or family member decides to go back to work, either full or part time, in order to make ends meet. If this is your situation and you feel that you need to improve you job skills or you need help finding work, see if your Area Agency on Aging has an Employment and Training Program. Some Area Agencies do offer this federally funded program that subsidizes a new employee in contracted agencies as they learn new job skills. The opportunity often leads to permanent employment with the agency. Should your Area Agency not offer this program, chances are that another local agency has taken on that responsibility. The Area Agency can connect you.





Frequently, people who are being cared for at home need various types of supplies such as nutritional supplements, incontinence supplies, raised toilet seats, no-rinse shampoos, etc. Medicare and Medicaid do not pay for all the supplies that caregivers need.

A company called The Caregivers Group has put together a group purchasing program specifically for family caregivers. It is called The Caregivers Marketplace. The Caregivers Marketplace negotiates with manufacturers to get rebates and discounts and then makes them available to individuals who sign up to participate.

You will receive a "Savings Card", a catalog of products eligible for rebates, a directory of locations where the products can be purchased, and a list of companies that offer discounts to card holders. Card holders fill in a rebate form and return them to The Caregivers Marketplace with proof of purchase to receive a cash rebate. The company is paid for offering this service by the manufacturers who sign on. Enrollment is free for caregivers. Compare prices for items and you may find some good deals.

Triangle J does not endorse or recommend products or services. Each caregiver must evaluate the merits of the service and decide whether or not to participate.

To contact The Caregivers Marketplace call 1-866-327-8340 or link below.

Caregivers Marketplace




Discount Coupons

Sometimes paying for care means cutting costs overall. Remember to clip coupons. There are also websites that offer discounts on other products as well as grocery store coupons. To follow are just a few. Use your search engine to find more. Always read the fine print before signing up for the service. And, if you are a senior citizen, don't feel bashful about asking for any senior citizen discounts they may offer.

Cool Savings - a free service that allows you to print real coupons from your computer and access rebate information.

Value Pages - a free service that will send offers, promotions and other information by e-mail on categories that you choose such as automotive, computer hardware, cooking, education, health and beauty, travel, etc. They also provide online coupons and other discount information, including free samples, on the web site.

Value Pak - a site for free online coupons. Categories are: auto/transportation; beauty/fitness; entertainment/leisure; home services/improvement; medical services; professional services; retail; restaurants; and technology/communications.




Insurance Sellouts

It may be possible to sell your life insurance policy for cash. There are several options to choose from. Before you make this decision, however, be sure to discuss the implications with your attorney and insurance agent. If you change your mind about wanting coverage, it may be more difficult to obtain an affordable new policy or to even find anyone to let you buy a new policy. So, make your decision carefully and get all the facts before you decide.

Senior Settlement or Life Settlement
This is the sale of an existing life insurance policy by its owner to a third party. The owner receives a cash settlement in exchange for transferring ownership and all other rights of the policy to that third party.

Viatical Settlement
This is the sale of an existing life insurance policy by a terminally ill individual for cash.

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