Covering the Cost of Health Care for the Elderly

Are there resources available to help elderly people afford the rising price of health care? My mother has died and my dad is retired and living alone. He has a number of medical issues, and he's desperately afraid that his money won't hold out if he's hospitalized or forced into a nursing home. How can we help him?

To pay for high health-care costs, insurance is a necessity for most older adults. Supplemental insurance is important because Medicare doesn’t reimburse for some services, and the non-reimbursed costs can amount to thousands of dollars. In addition, some doctors refuse to accept direct Medicare payments because the fees assigned by Medicare are inadequate. For this reason, the patient is liable to pay in advance and assume responsibility for the charges that are not reimbursed by Medicare.

To qualify for Medicare coverage, your father must be entitled to payments under social security or the Railroad Retirement Act. For details on the enrollment process and up-to-date information on what is and what isn’t covered under Medicare, see the official U.S. Government website.

If possible, you should help your dad find a supplemental insurance policy that covers all charges above what Medicare reimburses. There are several standard “Medigap” supplement plans offered by private companies to fill the “gaps” in the original Medicare plan coverage. For updated news on Medigap insurance you can access Elder Web or call 1-800-MEDICARE. Other options might include employer or union coverage, private fee-for-service insurance plans, or religious fraternal benefit plans. Contact your state insurance department to find out which companies offer health plans, as well as the availability of state programs or protections for your aging loved one. The National Association of Insurance Commissioners (NAIC) website has links to each state’s insurance department.

When choosing a Medicare health plan, consider what your father’s out-of-pocket costs will be, whether he can see the doctors he wants to see, whether there are “pre-notification” requirements, and whether you will need coverage for extra benefits and services, such as hearing aids or prescription drugs. The cost of prescription drugs often represents a major financial hardship for many older adults. Medicare may cover much of the cost for medications but many older adults are faced with considerable out-of-pocket drug expenses. You can contact Medicare to determine what prescription drug plans are available for your father. Also, most pharmaceutical companies have programs to help low-income patients get the medications they need. Your father’s doctor should be able to direct you toward these programs. On occasion, a Medicare claim is denied. If this happens, the claim can be appealed to a higher authority, in which case there is a very good chance that the denial will be reversed.

Another source of help is Medicaid, a joint federal and state program designed to provide medical insurance assistance to people with low incomes and limited assets. Today, Medicaid pays for about two-thirds of all nursing-home care in the United States. A person who qualifies for Medicaid can use a variety of healthcare facilities if these facilities participate in the Medicaid program. For more information see the Centers for Medicare and Medicaid Services (CMS) website.

With the soaring costs of long-term care, some people believe the answer is found in long-term care (LTC) insurance. Most of the policies sold today cover various community-based options, such as nursing-home placements, home health care, adult day care, and respite-care services. It’s crucial to add that LTC insurance is often too expensive for elderly people to purchase. A good rule of thumb is that no more than 7 percent of your elder’s annual income should go to paying premiums.

The best course of action is to make plans in advance of a crisis. A qualified financial planner, CPA, or attorney should be able to provide guidance on matters (such as the disposition of real estate) that could affect your father’s finances in the future. It’s possible, of course, that a time will come when your loved one’s assets, savings, pension plan and other sources of income are insufficient to cover his medical expenses. If and when you see this situation approaching, you should turn to other family members, your church, and local elder agencies for whatever assistance they can provide. For suggestions and information we recommend you visit the website of the National Association of Area Agencies on Aging. You might also want to hold a family meeting (if there are siblings) to brainstorm ideas and pray together. Local, state and federal agencies can also help you find sources of assistance.

Meanwhile, we’d urge you to resist the temptation to give in to worries about your dad’s finances. Maintain a prayerful, positive attitude and keep in mind that being financially prepared is only part of the picture. What matters in the long run is that we “lay up for ourselves treasures in heaven” and make it a priority to share our spiritual heritage with our loved ones.

For additional help and information on this topic, we’d encourage you to consult the resources and referrals highlighted below. Or if you have relationship concerns and challenges associated with this situation, please don’t hesitate to give our Counseling department a call.


Caring for Aging Parents

Books on Finance


Caregiver Action Network

National Association of Area Agencies on Aging

Crown Financial Ministries


Caring for Ill or Aging Parents

Elderly Care

Financial Freedom – God’s Way

Money and Finances

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