Using Government Assistance to Help Pay for Alzheimer's Care

Senior Couple walking down the hallway of a care facility
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Without private insurance, it may seem like paying for Alzheimer's care will cripple the family budget. From Medicare to disability income, though, there are options for those without insurance. Although this assistance may not completely eliminate the financial burden associated with a diagnosis of Alzheimer's, these government and state programs can provide a helping hand along the way.

Medicaid

Medicaid is a federally funded program covering medical care for people who are below or close to the federal poverty level. Each state determines its own eligibility standards, services covered and rate of reimbursement for services. Medicaid typically covers all hospital services, home health care, long-term care and transportation to doctor's visits.

The income eligibility requirement for Medicaid is strict and will sometimes involve a "five-year look back." Medicaid representatives will look at the individual's financial history to see if any assets were transferred or sold below cost to family and friends in order to become eligible for Medicaid.

It is also important to note that not all providers accept Medicaid, so contact individual providers before beginning treatment. Visit the Centers for Medicare and Medicaid Services website for contact information to local Medicaid offices.

Supplemental Security Income

In addition to public insurance and medical assistance programs, the government provides help for some people who can no longer work because of a disability. In most cases, Alzheimer's disease qualifies as a disability.

To qualify for Supplemental Security Income, though, a person must have less than $2,000 in net resources. A couple cannot have more than $3,000 in net resources. The term net resources refers to money in bank accounts, cash, investments and real estate earnings. It does not include burial plots, a family's house or, in most cases, the family car. Contact a Social Security Administration office to learn more about the program. The national office can be reached by calling (800) 772-1213.

Social Security Disability Income

People who are disabled and no longer able to work also qualify for Social Security Disability Income. According to the Social Security Administration, a disability is defined as follows:

  • If the individual is working in 2020 and their earnings average is less than $1,260 a month
  • The individual's condition must significantly limit their ability to do basic work such as lifting, standing, walking, sitting, and remembering – for at least 12 months
  • The medical condition must be on the SSDI list of severe conditions. If it isn't the Social Security administration will make a determination if the condition is as severe as the ones on the list

Benefits will vary greatly by individual, but they will continue until the person receiving benefits either passes away or turns 65. At that time, although the amount should remain the same, payments will instead originate from Social Security's retirement program.

Medicare

Traditionally a program for those older than 65, Medicare does provide government-funded insurance to some people receiving Social Security Disability Insurance. People under age 65 who are interested in enrolling should visit the Centers for Medicare and Medicaid Services website or contact their local Medicare office by calling (800) MEDICARE.

Medicare insurance typically covers 80% of care that does not require hospitalization and 100% of hospital care after a small deductible is met. According to the Fisher Center for Alzheimer's Research Foundation, Medicare will cover "reasonable and necessary doctor's visits; physical, occupational or speech therapy; psychotherapy or behavioral management therapy by a mental health professional; and skilled home-care services" for qualifying patients with Alzheimer's disease.

Caregiver Support Programs

Most states provide some sort of assistance to family members who provide long-term care. These assistance programs can include everything from help with finding and funding adult day care to providing counseling for the caregiver.

Programs, as well as eligibility requirements, vary greatly. For more information or to find a state office, contact the National Family Caregiver Support Program, a division of the U.S. Administration on Aging, at (202) 619-0724.

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  1. Social Security. Supplemental security income (SSI) resources: What are resources?.

  2. Social Security. Disability benefits: How you qualify.