The money map / Start here
Start here
Start here: the order to read this desk in
Seven stops, each one a question you have to answer before the next one makes sense. Read them in order the first time. After that, jump to the column you are stuck on.
You landed here because someone in the family needs hours of help at home, and the question on your desk is who pays for them. The honest answer is that it depends on five things you may not know yet: which kind of Medicare the parent has, whether a long-term care policy exists, whether the parent served, what has already been signed, and how much money there is. This path takes those in the order that saves the most time.
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Draw the whole grid once
Before you chase any single payer, see all five in one place. The master grid puts Medicare, MO HealthNet, the VA, a long-term care policy and private pay across the top and the ordinary jobs at home down the side. The second read walks the same payers in the order most families try them.
Who pays for in-home care for elderly parents?
How do I pay for a caregiver for my mother? -
Settle the Medicare question early
Most of the wasted weeks happen here. Families wait for Medicare to send someone for the daytime hours, and Medicare's own coverage page lists 24-hour care, homemaker services and personal care that is the only need as things it does not pay for. Read these two so you know which help Medicare can send and which it cannot.
Does Medicare pay for in-home care for an elderly parent?
What is the difference between Medicare home health and home care? -
Find out whether a policy exists
A long-term care policy can be the largest source of money for hours at home, and it is often sitting in a drawer. The federal LongTermCare.gov pages explain the two gates every claim passes: the benefit trigger and the elimination period. These three reads cover finding the policy, reading the schedule page and filing.
How do I know if Dad's long-term care policy covers home care?
What is an elimination period on a long-term care policy?
How to file a long-term care insurance claim for my father -
Open the Missouri door if the money is thin
MO HealthNet can pay for personal care, chores and respite at home for people who qualify, but only after an application and a state approval. Read the two-doors article first. Then read the look-back article before anyone moves money to the children, and take gifting questions to an elder law attorney.
Missouri Medicaid in-home care for elderly parents: two doors, in order
If I gift money to the children, what does the Medicaid look-back do? -
Get the legal authority to pay the bills
Every column above eventually needs someone who can sign, call the bank or talk to the carrier. That authority has an order, and the order matters most while the parent can still understand what they are signing. Start with what to sign first, then read the others as your situation calls for them.
What do I sign first when a parent can no longer manage money?
How do I get a power of attorney for an elderly parent?
Can I use my dad's bank account to pay for his care?
What is the difference between a power of attorney and a joint bank account?
How do I apply to be Social Security representative payee for my mother?
What documents do I need to manage Mom's finances and care? -
Work out the runway
Private pay is the column that is always open, which is why it deserves real math. The runway worksheet uses the rate a company quotes you, her monthly income and her savings. This desk supplies no price. The tax read points to the three IRS publications a CPA will want to see.
How long will Mom's savings last paying for home care?
Is in-home care for my mother tax deductible? -
Use the free help before the paid kind
Missouri SHIP counsels on Medicare for free and sells nothing. The Area Agencies on Aging know the local programs. The Missouri Bar runs a free lawyer search. Read the free-help article, then keep the local help directory open in a tab.
If you only have ten minutes. Read the master grid, then the comparison table on the front page, then call Missouri SHIP at 800-390-3330 with your Medicare question. That alone rules one column in or out.
This path is educational, not legal, medical or financial advice. Where a question turns on capacity, eligibility or a tax return, the reads say so and send you to the physician, the program, an elder law attorney or a CPA. How the desk writes and what it will not do is on how we write.