Ways to Receive and Pay for Care


There comes a point when a spouse or other loved one can't provide care any longer, either due to financial, emotional, or health reasons. That may lead to the need to find a long-term care provider. Some people make arrangements ahead of time, especially if there is a family history to consider, but most are in response to an immediate or impending need. The list below the video will give you a general idea.


Here are some of the most common (and some recommended) ways most people receive and pay for care:

  • Pay for home care or adult day-care yourself to receive it in the most dignified setting for as long as possible. 1
  • Qualify for Medi-Cal (Medicaid in California). This only covers costs in skilled care facilities. 2
  • Downsize your home  to live in a community that has progressive care included in the association costs. 2
  • Move into an assisted living facility. 2
  • Receive a check from having purchased a long-term care insurance policy. 3
  • Go directly into a skilled care facility after a hospital stay of three days or longer to have Medicare pay for the first 20 days and a portion of the costs for the next 40 days or so. 4
  • Start saving the amount equal to the premium and build an account earmarked exclusively for potential care costs. 5
  • Set aside enough assets to have the interest pay insurance premiums. 5
  • Receive assistance in your community or from a religious organization. 6


  1. Very few people have acquired insurance to cover these costs. Most are paying from their own personal savings, or that of their children. Some people purchased hybrid annuities that are a combination of a deferred annuity with a long-term care or chronic illness component. If you or a spouse needs care, you can access the funds in the annuity without having to pay federal taxes on the withdrawals. It’s important to understand the surrender charges as they may be high and the surrender periods may be long. However, you can always access up to 10% of your original premium payment, as with any annuity.
  2. More common for a single person or surviving spouse. Be sure to consult an elder law attorney before considering or applying for Medi-Cal.
  3. Many older policies with annual premium payments have seen significant premium increases in the last several years. Realize that policies that are not paid up or have contractual payment arrangements may continue to increase over time. California has passed a law limiting premium increases in the future, which may lead more companies to eliminate some forms of coverage.
  4. That is all Medicare will cover. Medicare may not pay anything if someone goes into a facility from anywhere other than a hospital and it will pay nothing for home care either. The facility must be Medicare certified. Most other health insurance does not provide any coverage for a long-term care need.
  5. People need to start this early enough in life so the funds have time to build.
  6. Some valuable resources can be found on our Long-Term Care Resources page.