Financial Assistance Programs

When considering how to arrange the financial accounts of an individual suffering from Alzheimer’s disease, it is crucial to also consider what type of financial assistance the individual may eventually require as the Alzheimer’s condition progresses. There are a variety of programs available to help defray the cost of institutional care and medical services. These are briefly outlined in this section.

Income and asset limits for most assistance programs change annually. For current guidelines or more specific information, visit related web sites mentioned or contact the appropriate agency. If you have questions about how to get in touch with financial assistance providers, use one of these resources for information and assistance:

  • In other Florida counties, call the state Elder Helpline toll-free at 1-800-963-5337. This number connects to an elder helpline in your area.
  • Nationally, call the Eldercare Locator toll-free at 1-800-677-1116. This number, sponsored by the U. S. Administration on Aging, connects to elder helplines all over the United States. You may want to use the Eldercare Locator web site.

Social Security Disability

When a disabled individual has had Social Security deductions made from his paycheck and has worked in the preceding five (5) year period, he may qualify for disability benefits from the Social Security Administration. If the Social Security Administration awards disability benefits, the recipient receives monthly cash benefits based on the amount of money he has paid into Social Security. The payments continue as long as the disability persists. After two (2) years of receiving disability benefits, the individual also becomes eligible for Medicare coverage.

If the disability continues until the recipient reaches retirement age, the Social Security Administration converts the monthly disability check to a Social Security Retirement check. In some cases a disabled individual age 50 or older, who is the widow/widower or ex-spouse of a deceased worker may also qualify for Social Security benefits. For information about Social Security Disability, Supplemental Security Income or Medicare, call the U. S. Social Security Administration toll- free at 1-800-772-1213.

Supplemental Security Income (SSI)

Supplemental Security Income is a benefit which can be given to an individual whose monthly income and assets are below amounts that change annually. In addition to these financial eligibility criteria, the applicant must meet age requirements (65 or older) or must be able to establish a disability according to Social Security Disability guidelines. SSI pays cash benefits and entitles the individual to automatic Medicaid assistance. Use the Social Security contact information listed above for SSI information.

Medicare

Medicare provides assistance for hospitalization and doctors’ costs if the individual has paid into the Social Security fund and either has been receiving Social Security Disability benefits for two (2) years or has attained age 65. There are limitations of Medicare coverage. For example, Medicare, in contrast to Medicaid, does not pay for prescriptions. In some instances, it is possible to qualify for both Medicaid and Medicare. For information regarding Medicare, call 1-800-333-7586 or visit the Medicare web site.

Veterans Benefits

The U.S. Department of Veterans Affairs (VA) administers Non-Service Connected Pensions. The non-service connected pension is for wartime veterans who are considered permanently and totally disabled and meet the VA’s income and asset limitations. This pension could be used to offset the cost of medical or nursing care for the veteran. Contact:

For more about Veterans Administration services and links to related web sites, see Benefits Older Veterans Should Not Overlook.

 

The Florida Department of Children and Families Adult Services Program Office administers the following programs:

Home Care for Disabled Adults (HCDA)

This program provides subsidy payments to assist relatives or interested parties in maintaining their physically or mentally disabled relatives in their own homes or family member’s homes, by providing financial incentives to families willing to care for their disabled relatives. Patients must meet certain eligibility requirements and must be at risk of nursing home placement as determined by the Adult Service Unit. Income and resources must be low enough to meet annual guidelines.

Institutional Care Payment (ICP)

The Institutional Care Payment (ICP) program provides Medicaid coverage for individuals 65 years of age or blind or disabled who require nursing home placement for either intermediate or skilled nursing care. To qualify, an individual’s countable income must not exceed the allowed monthly standard. The individual’s spouse who remains in the community may retain a certain level of countable resources.

Medicaid 

An individual qualifying for assistance through the ICP program, Hospice, (contact your local hospice, for eligibility criteria) or the SSI program becomes entitled to Medicaid. Medicaid provides payment for certain prescription, nursing home, hospital and doctor’s expenses. In addition, Medicaid under any of these programs will also pay the individual’s Medicare premium. In qualifying for Medicaid assistance through the above mentioned programs, there are three important resource exclusions:

  1. An individual’s actual homestead is not counted as a resource.
  2. Resources set aside in a burial trust fund are excluded up to a limit. Irrevocable burial contracts of any kind are excludable.
  3. One automobile, regardless of value, can be excluded.

Medicaid Medically Needy Program

This program is intended to provide Medicaid for persons with high medical bills whose income is too high to qualify for other Medicaid programs. Individuals qualify for Medicaid coverage on a month-to-month basis by meeting a monthly share of cost.

The individual’s resources must not exceed a certain level, but there is no income limitation if the share of cost is met.

Optional State Supplementation (OSS)

The Optional State Supplementation program provides funds to help cover the expenses of living at an Assisted Living Facility, an Adult Family Care Home, and Mental Health Residential Treatment facilities. To qualify for this assistance, the individual’s countable monthly income varies by type of facility and is subject to limits, as are assets.

Medicaid Buy In Programs

Qualified Medicare Beneficiary (QMB)

This program provides payment of the Medicare Part B premium, deductible and co-insurance for individuals whose monthly income and assets do not exceed the limit for this program.

Special Low-Income Medicare Beneficiary (SLMB)

This program provides payment of the Medicare Part B premiums for individuals whose monthly income does not exceed the limit for this program.

Qualified Individuals (QI-1)

Individuals who are eligible for QI1 are eligible to have Medicaid pay Medicare directly for Medicare premiums for Part B. The income limits are higher than SLMB and payment is only guaranteed through the end of the year the application was made. This is the only Medicaid benefit.

For information about OSS, Medicaid, Institutional Care Payment (ICP), the Medicaid Aged & Disabled (MEDS-AD), or the Buy In Programs (SLMB, QMB, or QI1), contact the Department of Children and Families in Pinellas and Pasco at 1-866-762-2237. To apply online go to Access Florida.