Special Needs Care for Adult Children: Cost of Care

Many adults with disabilities are cared for by family members and friends who are often not paid for their services. While home care aides, personal care assistants, special therapies and various living situations may be helpful and necessary, these services can be costly.

Factors Impacting Care Costs

• Geographical location. In areas with a higher cost of living, care costs will run higher. If you live near many metro areas, we suggest comparing the rates in nearby cities.  For example, if you live near Washington D.C., find out what the rates are for Baltimore Special Needs Caregivers and Alexandria Special Needs Caregivers too.
  

• Education and experience of caregiver. Caregivers with more medical or specialized training (such as nurses, certified nursing assistants, occupational or physical therapists) as well as those with more years of experience will command higher salaries than, for example, a college caregiver or recent college graduate just starting out in the field.

• Level or type of care required. A caregiver for a person whose disability requires skilled or total care may earn more than a caregiver whose primary function may be as a companion or to give reminders to a high-functioning adult.

Average Costs of Care

The cost of home care aides, adult day centers and nursing homes varies widely from state to state. Since many factors will affect the actual costs, these numbers below are only a general guide:

• Home care aides. On average, people pay $19/hour (with a range of $14-27) for a caregiver from a licensed agency. The aides assisted with activities such as bathing, dressing and toileting.

• Adult day care. The average cost per day is $61 (or $15,250 per year based on five days a week for 50 weeks). The range was from $31/day (or $7,750 per year) to $130/day ($32,500 per year).

• Nursing homes. For private rooms in licensed nursing homes, the private pay rate per year (not the Medicare or Medicaid reimbursed rate) was on average $77,745 and ranged from $65,000-120,000.

Government Benefits

Your young adult or adult child may be eligible to receive financial assistance through Social Security.

• Supplemental Security Income (SSI) Disability Payments. Children under age 18 may qualify for SSI payments -- which differ by state -- if they meet Social Security's definition of disability and their (as well as their family's) income and resources are within certain limits. At age 18, a child is considered an adult and different medical and nonmedical rules apply. For example, at this age only the individual's income and resources are considered (not the family's), which means that some people may become eligible for SSI at age 18.

• Social Security Disability Insurance (SSDI). These payments to adults who have been disabled since childhood are based on a parent's Social Security earnings.

Medicare and Medicaid

Some parents may obtain private health insurance for their adult children. Individuals with disabilities may also be eligible for Medicaid and Medicare programs.

• Medicaid is the largest source of needs-based health care financial assistance for people with disabilities. The program is both state and federally funded; you should check with your local Medicaid office for eligibility. Some services that might be covered include physician care and prescription medications, as well as nursing home or other long-term care support services.

• Medicare is a federally funded program providing medical coverage for people age 65 and older, people under 65 with certain disabilities and people of all ages with end-stage renal disease. Depending on a person's eligibility, the different Medicare sections may cover a variety of health benefits, from home health care and skilled nursing facilities - only as long as the patient can be shown to be making progress -- to physician services and prescription medication.

Helpful Links

Department of Health and Human Services: Centers for Medicare and Medicaid Services

Social Security: Benefits for Children with Disabilities

Deborah Elbaum, M.D. has three children and lives in Massachusetts. She writes about a range of family and medical issues.