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By Carol Marak - Aging Matters

Recently, a reader asked, “If you can’t afford to live in a senior care facility, or have family to take care of you what other options does a person have when they can’t take care of yourself?”

Many seniors survive on Social Security from month to month. The retirement years are challenging, and enjoying the golden years and living comfortably is only a dream. And once they retire, they struggle. They are in survival mode. Others, like the 10,000 Americans who turn 65 every day, are just now facing the reality.

When seeking care on the limited income of Social Security, there are a few options available for the personal help you need or for additional income to pay for care. Here are a few ways to make that happen.

Supplemental Security Income (SSI) – If you are receiving Social Security alone, consider applying for SSI. This federal benefit is available to those 65 and older, the disabled and the blind who have limited income and resources.

The average monthly benefit for an individual is $710 (2013) and $1,066 for a couple. Some states add a small supplement to these amounts.

Medicaid – In addition to Medicare, qualifying people 65 and older with limited resources can receive Medicaid. It provides coverage for inpatient and outpatient care, including costs that Medicare does not cover such as nursing home care and personal care services.

Medicaid Waiver program – State Medicaid plans or state plan amendments often indicate what types of services are covered under Medicaid. Contact your state’s Medicaid office and ask them about LTSS coverage – long-term care coverage. To find contact information for your state’s Medicaid office, visit the State Resources Map at, click on your state, and click the Medicaid agency link.

The program allows individuals to have active roles in the services they receive. Self-directed personal assistance services allow participants to:

Direct types of care that they receive and understand but cannot do (e.g., a person with a physical disability may wish to direct his or her own exercise program)

Choose who will be involved in providing their care

Include their own preferences, choices, and abilities in the service plan

States can target this program to people who already receive services under 1915(c) waivers and may want to direct their own care. States can limit the number of people who self-direct their care and can decide whether this program will be statewide or limited to certain areas.

Medicaid also offers nursing home stays for seniors on a limited income. For more information, contact your local Area Agency on Aging, Department on Aging, or the Ombudsman office in your city or community.

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By Carol Marak

Aging Matters

Carol Marak, aging advocate, She’s earned a Certificate in the Fundamentals of Gerontology from UC Davis, School of Gerontology.

Carol Marak, aging advocate, She’s earned a Certificate in the Fundamentals of Gerontology from UC Davis, School of Gerontology.