How Will We Pay for Care? A Funding Screener
Seven questions, none of them about who you are, and the answer is a list of offices rather than a verdict: Medicare Savings Programs, Medicaid long-term care, VA pension, your free state counselors, the area agency on aging, and an elder-law attorney if property is involved. Each one names who decides and what to bring. Estimate only, never a determination.
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Seven questions, none of them about you
No name, no address, no phone number, no Social Security number, no email needed to see the answer. Everything stays in this browser. "I am not sure" is a real answer and keeps the route on your list.
Before deductions. A rough figure is enough.
Not the house, not one car. A rough figure is enough.
What you are trying to pay for
The median for assisted living community in Texas is $5,666 a month, or about $67,992 a year. That figure is a survey median from an industry cost-of-care survey, not a government rate and not a quote.
Against savings of $40,000 and income of $2,200 a month, that is the arithmetic every route below is trying to change. Compare the kinds of care side by side.
Who to ask, and what to bring
In order. The first several cost nothing, and the last one is the only route on this page that charges. Take the list itself to the appointment if it helps — our who-to-ask page sorts the same offices by situation.
1. Medicare Savings Programs, and Extra Help with drugs
Decided by: Your state Medicaid office. Extra Help is decided by Social Security.
Four programs pay Medicare premiums, and one of them pays deductibles and copayments as well. Being in any of them brings Extra Help with prescriptions automatically. Millions of people who qualify are not enrolled, almost always because they read a limit and stopped.
For scale: the federal monthly income figure for QMB is $1,350 on your own and $1,824 for a couple. You entered $2,200 a month. Those federal figures are a floor — several states use higher ones and several disregard savings entirely — so being above them is a reason to apply, not a reason to stop.
What to bring
- Proof of income for everyone in the household — award letters, pay stubs, pension statements
- Recent statements for checking, savings and investment accounts
- Your Medicare card
- Proof of address and date of birth
2. Medicaid long-term care
Decided by: Your state Medicaid agency, and only them.
Medicaid is the largest payer of long-term care in the country. It is needs-based, so it begins once income and countable savings are inside the limits your state sets — which is what people mean by a spend-down. Every state also looks back at money and property given away before the application.
What to bring
- Five years of bank statements, if you can get them
- Deeds, titles and any record of property or money transferred to family
- Life insurance policies with a cash value
- A list of medical conditions and the care actually needed each day
3. VA pension with Aid and Attendance
Decided by: The Department of Veterans Affairs.
A wartime veteran, or their surviving spouse, who needs help with daily activities may qualify for an addition to the VA pension. The part that decides most cases is that unreimbursed medical expenses — including much of an assisted living bill — come off the income VA counts.
For scale: the maximum yearly rate with Aid and Attendance is $29,093 for a veteran living alone and $18,697 for a surviving spouse. Those are ceilings, not payments — VA pays the gap between the ceiling and your income after medical expenses come off it. An accredited representative helps with the claim at no charge.
What to bring
- The discharge document (DD-214 or its equivalent)
- A marriage certificate, and a death certificate for a survivor claim
- Every bill and statement for care, insurance premiums and prescriptions
- A physician's statement describing the help needed each day
4. A long-term care insurance policy, if there is one
Decided by: The insurance company, against the wording of the policy.
Policies bought decades ago are routinely forgotten, and some pay a daily or monthly amount once conditions in the policy are met. Find the policy before you need it and read what triggers it — most require help with a set number of daily activities, and many have a waiting period measured in months.
What to bring
- The policy document itself, including any riders
- The benefit trigger and elimination period, which are usually on the schedule page
- A record of what the person can and cannot do without help
5. Free counseling in Texas
Decided by: Nothing — they help you apply to the people who do decide.
Every state runs a program that gives free, one-to-one help with Medicare, Medicare Savings Programs and Extra Help. The counselors are paid by a federal grant rather than by commission, and they have nothing to sell. This is the single most under-used resource in the whole subject.
What to bring
- Your Medicare card and any current insurance cards
- A rough figure for monthly income and savings
- A list of prescriptions
6. Your area agency on aging
Decided by: Nothing — but they know what your county actually has.
The local office that knows what exists near you: meal programs, transport, respite for a family caregiver, adult day programs, and the waiting lists for each. Reached through the federal Eldercare Locator on 1-800-677-1116.
What to bring
- The ZIP code where the care is needed
- A plain description of the help needed each day
7. An elder-law attorney, if property or a transfer is involved
Decided by: Nobody — but they can tell you what a transfer will do before you make it.
A house, a second marriage, a family member already living in the home, or money moved in the last five years all change what is possible, and they change it in ways that are expensive to undo. This is the one route on this list that costs money, and it is usually cheaper before the application than after it.
What to bring
- Deeds, titles and account statements
- Any power of attorney or trust document already in place
- A list of transfers, gifts and property sales in the last five years
This is not a decision, and we cannot make one
Nothing on this page decides anything. Only the agency that runs each program can, and the only way to find out is to apply. People who are over a published limit are approved every day, because states count income and savings differently from the way a household counts them.
Applying costs nothing, and nobody may charge you a fee to file an initial application for these benefits. If someone offers to do it for a fee, for a share of any back payment, or as part of buying an insurance policy or an annuity, that is the moment to stop and call your free state counseling program instead. An elder-law attorney charging for advice about property or a transfer is a different thing, and a legitimate one.
What this screener deliberately does not do
It does not score you, rank you, or tell you what you are entitled to. It has no way of knowing how your state counts income, what your care needs look like on paper, or what a caseworker will make of the file — and any tool that claims otherwise is guessing with a confident font.
What it can do is make sure nothing on the list goes unasked. The commonest expensive mistake in this subject is not applying for something.
Who to ask next
We publish figures and explain how they work. We do not decide anything, and nobody who does is on this website. These are the people who can, and the first four cost nothing.
- Eldercare Locator — 1-800-677-1116 ↗Free
Run by the federal Administration for Community Living. Give them a ZIP code and they connect you to the area agency on aging that covers it, which is the office that knows what exists locally.
- Your State Health Insurance Assistance Program ↗Free
One-to-one counseling on Medicare, Medicare Savings Programs and Extra Help, from someone paid by a federal grant rather than by commission. The local name differs by state — HICAP in California, SHINE in Florida, SHIBA in Washington.
- Medicaid.gov — eligibility policy ↗Free
The federal rules Medicaid long-term care sits inside. Your own state agency administers them and is the only body that can decide your case.
- VA — find an accredited representative ↗Free
VA's own search for accredited Veterans Service Organization representatives, attorneys and claims agents. VSO representatives help with pension and Aid and Attendance claims at no charge.
- National Academy of Elder Law Attorneys ↗Directory is free; the attorney is not
Where to find a lawyer who does this work full time, if a transfer, a trust, a house or a second marriage is involved. Attorneys charge; asking one before you move money is usually cheaper than asking one afterwards.
Our own who to ask page sorts these by situation, and the paying for care hub holds the rest of this wing.
Verified 2026-08-02 against CareScout (formerly Genworth) Cost of Care Survey 2025, fielded July-November 2025 (effective 2026-01-01)— an industry survey, not a government figure. Why we use it.
Verified 2026-08-02 against Medicare.gov, Medicare Savings Programs — 2026 monthly income and resource limits; Extra Help limits from Medicare.gov drug-cost help; poverty guidelines from HHS ASPE (effective 2026-01-01)
Verified 2026-08-02 against VA current pension rates for Veterans (effective December 1, 2025), with Survivors Pension rates from va.gov and the medical-expense deduction rule from 38 CFR 3.278 (effective 2025-12-01)
Estimate only — not financial, tax, legal, or insurance advice. Only your state Medicaid office can determine your actual amounts.
Official source: Medicaid.gov — eligibility policy (your state agency decides) ↗
🎓 Understand this tool
What it is
Turns a handful of answers about a care situation into an ordered list of the offices worth contacting, with what each one decides and the paperwork to take to it. It is a router, not a test, and it produces no score, no verdict and no eligibility finding.
How it works
Each answer switches routes on or off. Having Medicare brings up the savings programs; wartime service, or being unsure about it, brings up the VA pension; an insurance policy anywhere in the family brings up the policy itself. Free help is always listed before paid help, and the body that actually decides is named on every route rather than implied.
Getting the most from it
- Say where the care is needed. "Not decided yet" is a real answer and keeps every route on the list.
- Pick the state, and give rough figures for income and savings. Rough is genuinely enough.
- Answer the three questions about veteran status, Medicare and any insurance policy. Choose "I am not sure" rather than guessing — it keeps the route rather than dropping it.
- Work down the list in order. The first several routes cost nothing.
- Print the page, or copy the paperwork list, and take it to the first appointment.
Reading your result
The order is the output. Free, high-value routes come first, and an elder-law attorney comes last because it is the only one that charges — not because it matters least. A route appearing on your list means it is worth asking about, nothing more and nothing less. A route that disappears when you change an answer was never a promise either.
What it can't tell you
Nothing here is a determination and nothing here is legal advice. The screener cannot see how your state counts income, what a caseworker will make of a file, whether a service record meets the wartime requirement, or what an old insurance policy actually says. Every route ends at an office because those offices are the only places these questions can be settled. The commonest expensive mistake in the whole subject is not asking.
Frequently asked questions
Most families pay out of pocket first, and Medicaid is the largest single payer in the country once savings are inside a state's limits. Medicare does not cover long-term custodial care at all. A wartime veteran or surviving spouse may have a VA pension nobody mentioned, and an old insurance policy may pay a daily amount.
Related calculators
Care Costs
What in-home care, adult day programs, assisted living and nursing homes cost in your state, converted to monthly and yearly figures from the hours you actually expect to use. The survey publishes each kind of care in a different unit, so the arithmetic that makes them comparable is ours, and it is printed beside every number. Estimate only.
Savings Programs
Four programs pay the Medicare premiums of people with limited income, and a fifth pays most drug costs. Answer two questions to see where your figures sit against the federal limits for QMB, SLMB, QI and QDWI, plus Part D Extra Help. Those federal numbers are a floor many states exceed, so this is an estimate, never a decision.
Aid and Attendance
Aid and Attendance is paid as the gap between a maximum yearly pension rate and your income for VA purposes — and unreimbursed medical expenses above five percent of that rate come off your income first. This estimate shows both figures, so you can see why people in assisted living qualify. Not legal advice; accredited representatives help free.
Look-Back
Medicaid examines a five-year window before an application, looking for gifts and property transfers, and one found there creates a penalty period that starts only once the money has already run out. Here is how that works, how fast a spend-down happens, and a printable worksheet. Not legal advice — your state agency decides.
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