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AlzWife Asked June 2023

Does original Medicare cover PCA services at home?

My husband has a 20/30 on the mini mental with a ex of Alzheimer’s. I need help caring for help. Does Medicare cover PCA or does he needs to be on Medicaid?

Llamalover47 Jun 2023
AlzWife: Medicare does not cover a PCA (Personal Care Attendant).

ChoppedLiver Jun 2023
Medicare does not cover in home care.

However, look at the tax law and you might be able to deduct some of their expenses as a tax deduction.

If the person is in Memory Care or SNF, it might be possible to deduct most of the cost as an itemized tax deduction.

It is worth it to read the IRS rules or consult a tax advisor if the person pays taxes on their income each year.

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lovelyliz Jun 2023
you have to spend down your savings for medicade. each state has a certain amount. dept of aging will explain all this. you can stay in the house until you die and medicade will seek recovery for his bill. its over whelming. the average senior citizen dose not have long term insurance.

lovelyliz Jun 2023
no it dose not. very expensive on your own through a agency. if you eventually have to go on medicade it takes 3 months to get. call your county dept, of aging for help on medicade. there is a estate recovery process once the other spouse dies.

AliOJ58 Jun 2023
No, Medicare does not pay need supplemental or LTC insurance. Suggest speaking with an elder care attorney to help clarify rules in your state, including Medicaid spend down and trust options, as Services and eligibility vary by state.

https://www.cms.gov/medicare-medicaid-coordination/fraud-prevention/medicaid-integrity-program/education/personal-care-services

taimedowne Jun 2023
Medicare doesn’t cover in-home care except for hospice and I don’t think Medicaid does either. Medicaid will cover care in a facility, though.
Horseshoemama6 Jun 2023
Yea unfortunately medicare pays for nothing for in home care and they pay for nothing in for long term care in a nursing home. So if my dad could have stayed home mom would probably have had to pay 20,000 a month. In lt care she only paid around 6,000 a month I don’t know if this is what you call a blessing but my dad went on hospice the day we moved him from rehab to lt care. He only lasted 6 weeks. I know this was a blessing for him because he wouldn’t like the way he was living. We were in the process of getting him approved for Medicaid and the aid and attendance benefit when he passed. The aid and attendance benefit would have pd around $1,200 a month weather he was at home or in the nh. My mom can still qualify for the aid and attendance benefit if she develops a serious condition right now she if she would qualify she would get around 900 a month. There again it would be for in home care or lt care. It takes at least 6 months to get approved but it is reto.

RedVanAnnie Jun 2023
No

KPWCSC Jun 2023
If eligible for VA, they provide caregiver benefits as well as financial Aid and Attendance. Also our local Council on Aging provides limited grants to pay for caregivers. I learned more about these by doing Google searches over and over. Some Medicare Advantage plans also provide them but regular Medicare does not.
taimedowne Jun 2023
As far as I am aware the VA does not cover in home care unless the disability was the result of an injury suffered in the line of duty. There is indeed the aid and attendance benefit, but that is limited by income and the maximum is something like $2300/month. If you know of a way to get the VA to pay for in home care I would like to hear it, because they are telling me they won’t
MACinCT Jun 2023
If he qualifies for Medicaid at home, help will only be a few hours per week. If he needs more care, then are an elder law attorney in order to protect your share of assets. It is well worth the cost if you can protect what you can live on.
AlzWife Jun 2023
Thanks. I don’t think a few hours will cut it.
AlvaDeer Jun 2023
No, personal care attendants are not covered by Medicare.

I would call your supplemental policy and check on coverage in that way. But in home help is very difficult to come by other than self-paying for it.

You may want to call your local council on aging for direction, and a trip to a licensed social worker may help you find what is available in your area.
AlzWife Jun 2023
Thank you. We don’t have supplemental so I guess it’s Medicaid. Thanks!

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