Managing Financial, Legal & Insurance Issues

When you're caring for someone with Alzheimer's disease, financial, legal, and insurance issues can seem overwhelming and complex. Seeking the advice of a professional and becoming informed about the issues is recommended. This will help you feel confident as you make difficult decisions in your role as Alzheimer's caregiver.

Financial Issues

An Alzheimer's disease diagnosis is often accompanied by new financial demands that are required to maintain care both within the home and outside the home. To ensure that enough money will be available to provide continuing care, keep in mind that as the disease progresses, so do the care requirements. Consider evaluating the following:

• Care expenses, both now and in the future, such as doctor visits, prescription medications, home health aid services, and housing (such as assisted living or nursing homes).
• Current sources of income, such as insurance, personal savings, investments, and employee or retirement benefits.
• Other financial resources available through government organizations. ²⁴

Legal Issues

It's important to plan ahead and address legal issues as soon as a diagnosis is made. Advance directives are documents that help a person with Alzheimer's disease state his or her wishes regarding treatment and end–of–life issues. These documents can include:

• Durable power of attorney for healthcare – appoints a person to make all decisions associated with health care.
• Living will – states a person's preferences on decisions for medical treatment and artificial life support.
• Last Will & Testament – states, among other things, who has been appointed to manage the financial assets and beneficiaries of the person with Alzheimer's disease.²⁵

Insurance Issues

Healthcare insurance can play a key role in helping to ease some of the financial burden of long–term care. Some families have private insurance and it's important to research coverage and speak to the appropriate company representatives to make sure you understand all the benefits available under the policies.

The most common forms of insurance, provided by the U.S. government, include Medicaid and Medicare:^{26, 27}

• Medicaid – Medicaid is a federal program whose eligibility and benefits vary by state. The program is typically administered by a state welfare agency. Medicaid covers all or a portion of nursing home costs. A person with Alzheimer's disease can qualify to receive long–term care only if he or she has minimal income and cash assets. For more information, visit http://www.cms.hhs.gov/medicaid/.
• Medicare – Medicare is a federal health insurance program for people over age 65 who are receiving Social Security benefits, however, not everyone is eligible. Medicare covers inpatient hospital care and a portion of other medical expenses. Medicare covers some, but not all, of the services a person with Alzheimer's disease may require. Applications for Medicare may be sent to a local Social Security office. For more information, visit http://www.medicare.gov.
• Medicare Part D – The Medicare Prescription Drug Program is an optional program. If you elect the Medicare Prescription Drug Program, which is also called Medicare Part D, you can sign up with any one of several health insurance companies that serve your geographical area. In return for a monthly premium, the health insurance company provides you with some or all of your prescription drugs. Check with your particular insurance plan to find out if Namenda^® (memantine HCl)* is covered. For more information, visit http://www.medicare.gov.

More Resources:

There are many agencies available to help you learn more about the financial, legal, and insurance issues associated with Alzheimer's disease. Visit these websites for more information and guidance:

• The Eldercare Locator. Available at: http://www.eldercare.gov
• Centers for Medicare & Medicaid Services: Available at: http://www.cms.hhs.gov
• The American Association of Homes and Services for the Aging. Available at: http://www.aahsa.org
• The Assisted Living Federation of America. Available at: http://www.alfa.org
• National Institute on Aging. Available at: http://www.nih.gov/nia
• Alzheimer's Disease Education and Referral (ADEAR) Center. Available at: http://www.nia.nih.gov/Alzheimers/