Funding Sources to Pay for Services

We accept payments from private party payers, either from the clients themselves or their responsible party, usually a family member.

If you’re worried about Mom or Dad living alone, other family members may be worried, too. Working together, families can come up with a plan in which those who can’t help out because of geography or work demands pay siblings who do have that availability and flexibility to be with their parents on a daily basis. In another strategy, siblings who have available funds can pay an in-home caregiver or agency now with the understanding that they’ll be paid back for their contribution from the siblings’ collective inheritance or the proceeds of the house after the parents’ death. Either of these agreements needs to be spelled out very clearly to avoid tension, resentment, or dissension down the line. If a sibling acts as caregiver, she should have a set hourly wage and should keep close track of hours and any expenses incurred, such as gas or groceries, just as an employee would do. If a sibling pays for in-home care with the expectation of reimbursement, she should keep clear records in the form of invoices and receipts or canceled checks. It’s also a good idea to have something in writing to show the executor of the will or even to put a clause in the will explaining the plan.

Some of our clients have the fortitude to prepare themselves financially for what may occur to them if the unfortunate health issues arise. They took out Long-Term Care insurance just in case. Some Long-Term Care insurance plans provide coverage for home health care, so be sure to check benefits statements and policies carefully. You may want to contact the insurance providers to clarify what is covered by the elder’s plan. The provider may require the elder’s written or verbal permission in order for you to be able to discuss his or her insurance. Be sure to find out from the provider what is required, so you can gather the necessary materials. MetroCare Hawaii works with most long-term care insurance companies, so make sure to find out if your loved one has a policy. We can also work with you to make the billing process less stressful for you.

A State and Federally funded program designed to provide the indigent citizens within our community with the much needed health services that they otherwise could not afford. The Waiver Programs are one of many options available to States to allow the provision of long-term care services in home and community based settings under the Medicaid Program. States can offer a variety of services under an HCBS Waiver program. Programs can provide a combination of standard medical services and non-medical services. Standard services include but are not limited to case management (i.e. supports and service coordination), homemaker, home health aide, personal care, adult day health services, habilitation (both day and residential), and respite care. States can also propose “other” types of services that may assist in diverting and/or transitioning individuals from institutional settings into their homes and community.

Participants of this program are required to provide proof of income. Some restrictions apply! We do accept this type of payment arrangement through the various fund administrators. Check to see which program you can qualify for.

• Ohana Health Plan Well-Care
• United Healthcare
• Dept. of Health and Human Services
• Aloha Care
• Kaiser Permanente
• HMSA

• The Elderly Affairs Division (E.A.D) Kupuna Care Programs funded in part by the Federal and State of Hawaii
• Maui County Office on Aging (MCOA)
• Hawaii County Office of Aging (HCOA)

Payments are accepted for services rendered usually on a temporary basis and usually occurs after the client is released from the hospital or an institution and requires a continuity of care in the home known as restorative care or convalescent care.

When an unfortunate accident happens, it is nice to know that your needs will be met. We accept payment via this method provided your insurance issuer approved the type of services to be provided.

Nobody wants to be involved in an accident in the workplace, but it is reassuring that when the misfortune occurs, you are covered.

Some health insurance carriers offer a homecare rider in their policy, so inquire with your current provider if this rider is available.

With an HSA, you can make tax-deductible contributions each year to pay for current and future health care costs. What you don’t use in any given year will stay invested and continue to grow tax-free, assuming you eventually pull it out to use for medical costs. If you use any withdrawal for non-medical costs, it will be taxed when you use it – and if you are not yet 65, you’ll owe a 10% penalty too. So, draw on the account to pay medical costs only. The annual contribution limit to an HSA in 2013 is $3,250 for individuals and $6,450 for families. If you are at least 55 years old, you can contribute an additional $1,000 in 2013.

Life insurance policies are used as a funding source as well. They can be surrendered for their cash value or converted to cash by using a life settlement. They may also be converted to long-term care benefit where you will withdraw an x-amount of money monthly to pay for homecare services.

Trust funds are financial tools that hold and administer assets for the benefits of another person or organization, called a beneficiary. The initial assets for the fund are provided by a grantor or donor, and a trustee or team of trustees manages the funds according to that person’s instructions. The beneficiary receives payment from the fund as a lump sum or in periodic installments, according to the terms of the trust. Trust funds are often used to set aside property, investments, or cash assets to provide for people who are unable to manage their finances for themselves, like children or people who are ill. This is often used by people for themselves under the assumption that they will become unable to manage their personal finances sometime in the future.

If your loved one has equity in their home, they can probably qualify for a reverse mortgage. A reverse mortgage is a loan for people above the age of 62 that uses some percentage of a home’s equity as collateral in exchange for cash to the borrower most often in monthly payments. Typically, the loan is not repaid until the last surviving homeowner permanently moves from the home or passes away. If one of these are to occur, the estate has approximately 6 months to repay the amount owed on the loan or sell the home to pay the balance. The remaining equity in the home belongs to the estate and the estate is not personally liable if the home sells for less than the balance of the loan. Please see a Certified Reverse Mortgage Specialist for more information on this awesome, yet underutilized money source.

You can use a portion of your retirement income to pay for essentially Home Care services.

If your loved one’s income is low and she has very little in the way of savings or other financial resources, she may qualify for Medicaid-covered in-home care, at least on a limited basis. Medicaid rules vary state by state, but all programs cover short-term in-home care for acute conditions.

It’s not easy to get Medicare coverage for in-home care, and when you do, it’s strictly limited. That said, it can be God-sent when you’re faced with a sudden medical crisis or downturn in your loved one’s condition. Medicare coverage is most common when your loved one is being discharged from the hospital or a rehabilitation facility. You’ll contract through a Medicare-certified agency for a period of skilled nursing care and therapy that’s tied to a certain period of expected recovery. The good news is that Medicare coverage is easier to get than it used to be, and in the year 2013, it should become easier still. Thanks to the settlement of a lawsuit, Medicare coverage for skilled nursing care and occupational and rehabilitative therapy – either at home or in a nursing home — can’t be limited by whether or not the patient’s condition is improving. Prior to the lawsuit, Medicare criteria would cover treatment only if the patient’s condition showed improvement which meant that people with chronic conditions like COPD, heart failure, Parkinson’s, and Alzheimer’s lost coverage after a certain period of time.

• Foundation
• In-Home Care Benefit Program
• Alzheimer’s Respite Program
• Catholic Charity Foundation
• Veteran Administration Respite Program
• V.A. Aid & Attendant Care Pension Benefit (benefit that you can use to pay for home care services)