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2023 AARP Report Recommends Supports for Family Caregivers

Many older Americans choose to have their family members care for them as they age. Despite the comfort a familiar face may provide, there is a significant cost for the loved ones who sacrifice their time, and often their upward economic mobility, to ensure that they can secure proper care for their senior parent.

In a report issued in March 2023, AARP stresses the importance of supporting family caregivers in their financial, emotional, physical, and professional lives. The analysis gives a glimpse into the experiences of family caregivers and also offers recommendations on policies, practices, and programs – across public as well as private realms – that policymakers should consider enacting or enhancing in support of caregivers and the individuals who are in their care.

How Much Does It Cost to Be a Family Caregiver?

Being a family caregiver can come at a great financial cost. The average cost of caregiving has risen exponentially in the past several years, and the trend is expected to increase more over time.

In its report, AARP estimates the value of family caregiving in 2021 at $600 billion dollars in unpaid contributions – up from $470 billion dollars in 2017.

The monetary value of caregiving is not the only cost of care. For family caregivers, some of the intangible costs of included:

• spending an average of 18 hours per week to tend to the needs of their loved ones
• facing higher risks of chronic loneliness, which may have negative health effects
• neglecting their own self-care

What Are the Major Issues in Family Caregiving?

According to the AARP report, by 2034, the population of people over 65 will outnumber the population of children under 18. With this historic shift, the researchers suggest that the impact on family caregiving will become even more prominent in several key areas:

The Need for Tailored Support for Diverse Caregivers and Their Families

Family caregivers across diverse cultures, ethnicities, sexual orientations, and gender identities often face concerns about access to support that is specific to their community. Ensuring that affordable, inclusive, readily available policies and services are in place to meet these needs of these caregivers will continue to be critical.

Direct Care Workforce Shortage

Amid a shortage of professional caregivers that only worsened during the COVID-19 pandemic, AARP notes that the turnover rate among the direct care workforce averages between 40 percent and 60 percent each year. Failing to recruit and retain a dedicated workforce in caregiving as the aging population grows will inevitably add to the burden carried by unpaid family caregivers.

Economic Impact on Working Caregivers

Most family caregivers – nearly two-thirds of them in 2019, according to AARP – hold a full- or part-time job in addition to caring for their loved ones. These workers often take an economic hit because they need to split their time between their jobs and their home responsibilities.

Without such supports as telecommuting, paid leave, and respite care, they may have no choice but to call out of work, turn down promotions, or even leave their job altogether to dedicate themselves fully to providing care. This can then mean additional financial stress as well as adverse effects on their career and future earning potential.

A Growing Sandwich Generation

In 2019, about 30 percent of older Americans were living with their children or grandchildren. The so-called “sandwich” generation represents those who are responsible for caring for their children and their aging parents at the same time, while also working. These caregivers, who are likely to report more emotional and financial pressure, now tend to include workers across an ever-expanding age span – from 35 to 64.

Recommendations

The AARP’s report recommends specific policies and practices to support family caregivers going forward. These recommendations to policymakers include the following:

• Including family caregivers in planning and decision making across health care settings
• Improving access to respite care for family caregivers
• Ensuring that publicly funded programs and supports for caregivers are inclusive, culturally appropriate, and designed to meet the needs of diverse populations
• Offering family caregivers a tax credit
• Expanding protections for workers who rely on the Family and Medical Leave Act and related state programs while providing long-term care for family members, including instituting paid leave for working family caregivers
• Allowing for other programs that pay family caregivers
• Improving Social Security benefits for people who provide long-term care services to family members

Additional Resources

Having a care plan in place for your loved ones in advance may help decrease the financial costs and other stresses associated with paying for long-term care for aging adults. Your elder law attorney can help you create a comprehensive long-term care plan that will address the costs associated with tending to the people you love. 

What Is Hospice Care at Home?

Hospice care is a type of health care that patients with terminally ill conditions rely on at the end of their lives. This type of care focuses on pain management and emotional, spiritual, and familial support for patients nearing the end of their lives.

There are several options for receiving hospice care, including being cared for at home. The type of intimate care a patient receives while in hospice is more conducive to being received at the patient’s home. This becomes a team effort, and it helps to have a peaceful environment when receiving care.

Who Can Benefit From This Type of Care?

Patients with serious illnesses like cancer, heart disease, dementia, kidney failure, or other fatal conditions benefit from hospice care. This type of care can help the patient live a more comfortable life while decreasing the emotional burden of grief for families by preparing them for the loss of their loved one.

When Is Hospice Recommended?

Hospice care should not only be considered by those who have loved ones nearing the end of their lives. While most of these services are generally reserved for people with six months or less to live, early hospice care can be beneficial for patients and their families as well.

You may wish to consider such services in the following cases:

• The patient has a serious decline in their physical well-being
• After a diagnosis of Alzheimer’s disease or dementia
• You have decided to forgo any treatment to improve your physical treatment or care for your illness

Who Makes Up a Hospice Care Team?

Your hospice team can consist of many different types of people. Various professionals and volunteers may be involved in end-of-life care. Some of those you may see on your care team can include:

• Doctors
• Nurses
• Social workers
• Spiritual advisors
• Trained volunteers

Who Pays for Hospice Home Care?

Like any other health care option, these services can quickly become very expensive. Fortunately, there are several ways to cover the cost, including:

Government Programs

If you qualify for government assistance, there may be insurance plans specifically designed to cover the cost of hospice care.

Seniors enrolled in Medicare Part A may qualify for a Medicare hospice care benefit. This benefit program allocates money to pay for such care at home.

For terminally ill patients on Medicaid, hospice care may be covered depending on the state.  

The Department of Veterans Affairs may also provide coverage for these care benefits for seniors who have served our country.

Private Insurance

Check the terms of your insurance policy to determine if your health insurance covers hospice care. Your policy may cover all or part of your hospice care needs.

Options for Uninsured Patients

Even if you do not have health insurance, you may still have coverage options. There are charitable organizations that work with elderly and disabled individuals who need help paying for hospice care services. Hospice care organizations also often have internal departments that work with patients who qualify for this type of care but are indigent or do not have health insurance.

Is In-Home Hospice Right For You?

Making this choice is an important part of your end-of-life care plan. Be sure to gather as much information as you can before deciding whether this type o care is best for you. For example, you may want to consult Medicare’s hospice compare website or CaringInfo.org’s website for other hospice locator tools.

If you have questions about Medicare or Medicaid, contact your elder law attorney to learn more.

Bill Advocates for Seniors Who Seek At-Home Medicaid Care

Seniors who need assistance with everyday activities such as dressing, bathing, and eating are eligible for Medicaid Long-Term Services and Supports (LTSS). Unfortunately, hundreds of thousands of people who qualify for these services – but wish to receive them in their homes or a community setting – end up on extended waiting lists.

In many cases, these seniors then find themselves with no choice but to live in nursing homes or other institutional facilities for months, or even years, if it is the only way they can access the day-to-day support on which they rely.

A piece of legislation focused on meeting the needs of this population of older adults has recently been reintroduced to Congress by U.S. Sen. Bob Casey (D-PA) and U.S. Rep. Debbie Dingell (D-MI).

Aging in Place: When You Want to Live Independently

Living at home as you grow older can have a positive impact on your physical and emotional health, as well as on your wallet. According to one 2022 study, aging in place includes such benefits as the following:

• Maintaining a sense of independence and autonomy in one’s community
• Living in a familiar setting
• Enjoying a more fulfilling social network
• Decreasing feelings of loneliness
• Saving on the cost of long-term care facilities

Where Does the Medicaid Waiver Fit Into HCBS?

Older adults qualifying for Medicaid LTSS who wish to receive services in their home or community generally must wait to be granted a waiver before Medicaid will cover the cost of their home care.

As each state administers its own Medicaid system and waiver program, the wait time can vary depending on where you live. The income and asset thresholds for waiver programs can also differ from state to state, as can the types of home care that are covered.

These are among the main reasons why you may want to consult with your elder law attorney, who knows the rules and regulations specific to the state where you reside.

Home and Community Based Services (HCBS) Access Act

The Home and Community Based Services (HCBS) Access Act, originally introduced in 2021, seeks to secure for these seniors a real choice between receiving care at home or in an institution.

A one-page PDF summary of the HBCS Access Act outlines six specific steps that the proposed legislation is designed to provide:

• Enhanced Medicaid funding for HCBS
• Grant funding for states that would develop their capacity to serve individuals who prefer to receive home care
• Resources for states meant to ensure professional caregivers have stable jobs and wages
• A stronger workforce in home care
• Training for family caregivers
• Improved methods for evaluating the quality of HCBS

According to a 2021 report from Justice in Aging, 25 of the 50 states spend twice as much on institutional care as on HCBS for seniors and people with disabilities.

In addition to seniors eligible for Medicaid LTSS, many people with disabilities would benefit from the legislation if it is passed.

Support From Others

Sixteen U.S. representatives are co-sponsoring the HCBS Access Act, and numerous advocacy organizations for older adults have endorsed the legislation as well.

“I’m helping introduce the HCBS Access Act, which expands Medicaid HCBS funding that will help ensure Americans don’t have unnecessary delays in accessing the care they need,” U.S. Sen. Jeanne Shaheen (D-NH), one co-sponsor, said in a news release about the Act. "This bill is an important investment not only in the accessibility of care, but also in creating better jobs for home care workers and support for family caregivers.”

Earlier this year, Sen. Casey and Rep. Dingell also reintroduced a related bill, the Better Care Better Jobs Act. The goals of this legislation are to boost funding for HCBS, make millions more individuals on Medicaid eligible for these services, and create new jobs for home care workers.

Because Medicaid can be such a complex system to navigate, be sure to consider consulting with your elder law attorney.

Study: Certain Social Risks May Cause Early Death in Seniors

Using survey data from more than 8,000 adults aged 65 and older, researchers have identified eight social factors that may lead to early death in older adults.

As part of the study, researchers from Massachusetts General Hospital and the University of California, San Francisco, developed a tool called the Social Frailty Index to examine factors that predict mortality, including age, gender, and medical conditions, as well as social characteristics.

The findings have applications in clinical, population health, and research settings. Clinicians may be able to use the index to help their older patients participate in advanced care planning. The index also helps identify at-risk seniors who could benefit from changes to their social interactions that could extend their lives.

8 Social Characteristics Shared by Study Participants Who Died Prematurely

Following 8,250 seniors for four years, the research team discovered that 22 percent of the group died within four years of their baseline interview.

The participants who died prematurely had the following eight social characteristics in common:

1. Poor neighborhood cleanliness
2. Low perceived control over their financial situation
3. Meeting with children less than yearly
4. Not working for a salary
5. Not being active with children
6. Not volunteering
7. Feeling isolated
8. Being treated with less courtesy or respect

Why Are the Social Frailty Index Findings Important for Older Adults?

The Social Frailty Index reveals the potential impact of healthy social connections on seniors’ physical health, according to the study’s authors. These findings, they state, are significant because medical providers previously had not accounted for these characteristics. Health care providers taking these findings into account may be able to give patients a complete care management plan.

“We often overemphasize the importance of medical conditions when thinking about longevity,” Sachin J. Shah, the study’s lead researcher, said in a news release. “This research demonstrates that our social lives are as important as medical conditions.”

The data collected from the study also helps predict the likelihood that a senior can safely and comfortably age in place. Solid social connections correlate with the ability of older adults to live independently.

Failure to consider social factors can lead to more significant inequities. For example, one of the authors states, Medicare penalizes hospital readmissions. Because of the expense of rehospitalization, some hospitals may refuse to admit Medicare recipients. Omitting risk factors creates a more significant barrier to proper treatment for marginalized groups. Patients can therefore avoid rehospitalizations if clinicians recognize and account for social factors when assessing a patient’s risk factors.

What Can Seniors Take From the Study?

This study’s findings suggest that friends, family, and community can help you live a longer and happier life. Armed with the knowledge from this study, seniors and their caretakers can structure their lives to address the eight social factors listed above.

This study also provides older adults and caregivers with the language to address these conditions with doctors, estate planners, geriatric care managers, and other family members to help ensure their needs get met.

Becoming a Family Caregiver for an Ailing Loved One

Taking on the responsibility of providing full-time care for an aging or disabled loved one can be a rewarding experience. Being a primary caregiver helps you rest assured that your loved one is receiving compassionate care from someone who will go above and beyond to ensure they are comfortable and looked after.

Despite your good intentions to create a comfortable environment for your loved one, full-time caregiving is a significant time commitment. There is also a financial reality that the caregiver must face. Fortunately, family members who want to serve as caregivers may have options to help cover the expense.

What Is a Caregiver, and What Do They Do?

Professional caregivers work intimately with seniors to meet their needs as they age. As individuals get older, their needs change and they may need more help going about their day.

Examples of the kinds of help caregivers provide include:

• Bathing and grooming
• Help with toileting
• Medical appointments and medication compliance
• Transportation
• Companionship
• Cooking, cleaning, and grocery shopping
• Care for animals
• Laundry
• Coordinate benefit care/speak to insurance companies on the senior’s behalf, if authorized

Family Caregivers: Know the Downsides

Having a family member serve in the role of caregiver can make for a better experience for your loved one and, in some ways, give you peace of mind as well. However, there are some downsides to be aware of if you are considering becoming a family caregiver.

Your own health, both physical and emotional, can be negatively affected when taking on the burden of caring for a family member. Be sure to engage in self-care, maintain a healthy diet, and watch out for signs of stress and burnout. When you do need a break, consider looking into respite care.

If your loved one has specific medical issues that will require the attention and expertise of a professional health care provider, you may want to reassess whether you should take on the role of family caregiver.

Taking care of a loved one who is getting older or who is disabled will likely require a great deal of your time, too. You may find yourself not performing as well at work or having a longer commute as you fulfill the needs of your ailing loved one. Not to mention that your own immediate family may be missing out on valuable time with you while you are caregiving elsewhere.

In turn, this could mean you will have less time to hold down a full-time job. In fact, a 2020 AARP survey showed that about 20 percent of family caregivers reported experiencing a high level of financial stress. Nearly 30 percent of them stopped saving altogether as a result of providing care for their loved one.

In these challenging economic times, you must be able to support yourself while ensuring the best care for your aging family member.

Can Family Members Get Paid for Their Work as a Caregiver?

Fortunately, certain programs are available to help family members care for ailing relatives. You may need to do a bit of research to find the right option for your circumstances.

• Medicaid Self-Directed Care

For individuals on Medicaid, the Medicaid Self-Directed Care Program is one option that gives them the authority to manage their services. In certain states, this program offers recipients the ability to use the resources allocated for home care to pay a family member to help them with their daily needs. The Medicaid Self-Directed Care Program lets seniors have more autonomy over their care.

Note that such programs vary by state, however, and not all states will have an option like this. Each state may also use different criteria to define who qualifies as a “family” caregiver. Find your local Area Agency on Aging to learn more about the possibilities, or call your local Medicaid agency.

Note that, generally, Medicare will not cover the costs of caregiving by a family member.

• Veteran’s Benefits

If your loved one is a military veteran, there are special benefits available to cover their home care, including the Veteran’s Directed Home and Community Based Services program. This program gives veterans a flexible spending budget that the veteran can use to pay a family member to act as their caregiver.

• National Family Caregiver Support Program

Note that this program does not pay caregivers directly. Rather, it helps fund several different types of services for family caregivers, from training in caregiving to respite care. Learn more about this program.

• Long-Term Care Insurance

If you are thinking ahead to who will care for you as you age, you may consider long-term care insurance when creating an estate plan. Certain long-term care insurance policies allow the policyholder to pay family members to work as caregivers. However, that is not true for every policy. Some policies do not allow policyholders to pay family members to work as caregivers if they live in the policyholder’s home.

Before taking out this type of insurance policy, you should speak to your attorney to ensure you are properly advised.

Aging Care: 6 Tips for Caring for Elderly Parents

Many adult children wonder what their aging parents may need and how can they can help provide it for them.

You may constantly worry about your parents or other older loved ones, especially if you live far away from them. You can, however, take some simple steps to ensure your parents are safe as they age.

Tip No. 1: Recognize the Risks Older Adults Face

Knowing the risks seniors face can help you begin an action plan for your parents. It may be difficult for some older adults to complete tasks they could do before with ease, particularly if they live alone. Examples of those tasks can include:

• Taking medication correctly and on time
• Remembering things, keeping up conversation, or multitasking
• Getting help in a medical emergency, such as a fall
• Eating healthfully
• Moving safely around their home

Being aware of these common concerns can be an important first step in doing everything you can to protect your parents as they age.

Tip No. 2: Ensure Medication Compliance

If your parents have health conditions that require them to take medication regularly, you should take time to make sure they are adhering to their prescription instructions. It may be a good idea to routinely review the medications your parents take, the name of the medications, and any potential side effects.

You may consider creating a medication schedule that you can both follow, so that you (or a home care provider) can check in and confirm your loved one is remembering to take medications when necessary.

Tip No. 3: Prepare for Cognitive Decline

Alzheimer’s disease and other forms of dementia affect more than 5 million adults aged 65 and older, according to the Centers for Disease Control and Prevention (CDC). Keep your parents safe by understanding their current cognitive abilities and any risks they may face for future decline.

Consider setting up a routine for your parents’ day-to-day lives. This might include social engagement and spending time with you and other family members, which may become even more crucial if their cognitive health has deteriorated.

Tip No. 4: Equip Aging Parents for Medical Emergencies

Older adults that live alone are vulnerable to falls and other medical emergencies. If you live out of state, you may have concerns about your parents being able to act quickly in ensuring they get emergency medical attention when they need it.

To help your parents respond to emergencies, consider using a medical alert system. With a medical alert system, your parents will have emergency assistance at the push of a button. Many different companies offer this type of service. An online search can help you narrow it down.

Tip No. 5: Plan for Meals

Seniors, especially those that live with memory issues, may not eat regularly. Without adequate nutrition, older adults may fall ill, or any current condition may worsen. Many seniors across the United States are food insecure. Fortunately, there are certain Medicare Advantage grocery benefit programs as well as other free or inexpensive meal delivery services, such as Meals on Wheels, that deliver nutritious meals to seniors.

Tip No. 6: Prevent Household Injury

Household injury is a major risk for seniors, especially those who live alone. You should do a sweep of your parent’s home and remove all potential hazards, including unsecured electrical cords, household products and chemicals, or loose rugs. Fix broken handrails on staircases, install grab bars in bathtubs, and ensure there is adequate lighting in their home. Taking each of these steps, and any others you see fit, can help avoid a preventable injury.

Medicaid Expansion: What Might It Mean for You?

As of late 2022, more than 84 million people were enrolled in Medicaid — a number that has steadily increased in recent years. Amid the pandemic, total enrollees climbed by 20 million people from 2020 to 2022 alone.

Meanwhile, the debate among lawmakers on further expanding Medicaid in some 11 states continues to evolve. Depending on where you reside, passage of such an expansion could mean you become newly eligible for Medicaid.

What Is Medicaid?

Medicaid is a nationwide program designed to provide public health insurance for low-income individuals, including seniors and people with disabilities. Established in 1965, it serves today as the single-largest source of health coverage in the U.S.

Because Medicaid is jointly run by the federal government and state governments, its benefits — and your ability to qualify for them — can vary greatly depending on your state.

As a result, certain populations, even if they are living in poverty, may not be eligible for Medicaid. For example, in some states, a healthy, childless adult couple under age 65 with limited means may not qualify for health coverage through Medicaid if their state has not adopted Medicaid expansion.

What Is Medicaid Expansion?

Medicaid coverage across the country has evolved since the program was first created. Different states may employ different eligibility criteria, income limits, or application requirements.

In 2010, the Affordable Care Act (ACA) attempted to expand Medicaid coverage to adults between 18 and 65 with incomes below a certain level, regardless of their age, family status, or health. The ACA also sought to supply those whose incomes fell within specific limits with premium tax credits that would help them afford the purchase of a private insurance plan.

Yet, the Supreme Court ruled that the federal government could not force states to expand coverage. States can decide whether to expand Medicaid to cover more people. This has created a coverage gap: Those who have incomes below 100 percent of the federal poverty level and who live in states that have opted against expanding Medicaid may not qualify for Medicaid, or for the premium tax credits.

Medicaid Expansion States

As of early 2023, most states have adopted the ACA’s broadening of Medicaid. Per the Kaiser Family Foundation, the following states – in addition to the District of Columbia – have expanded Medicaid coverage per the ACA:

• Alaska
• Arizona
• Arkansas
• California
• Colorado
• Connecticut
• Delaware
• Hawaii
• Idaho
• Illinois
• Indiana
• Iowa
• Kentucky
• Louisiana
• Maine
• Maryland
• Massachusetts
• Michigan
• Minnesota
• Missouri
• Montana
• Nebraska
• Nevada
• New Hampshire
• New Jersey
• New Mexico
• New York
• North Dakota
• Ohio
• Oklahoma
• Oregon
• Pennsylvania
• Rhode Island
• Utah
• Vermont
• Virginia
• Washington
• West Virginia

States Without Medicaid Expansion

States that have not adopted Medicaid expansion per the ACA include:

• Alabama
• Florida
• Georgia
• Kansas
• Mississippi
• North Carolina
• South Carolina
• Tennessee
• Texas
• Wisconsin
• Wyoming

Medicaid Expansion Developments

The map of Medicaid expansion states continues to evolve, however:

• South Dakota voters approved a ballot measure adding Medicaid expansion to the state constitution in November 2022. The expansion will go into effect beginning July 1, 2023.
• In February 2023, the North Carolina House of Representatives passed a bill to expand Medicaid. It now awaits review in the Senate.
• Meanwhile, also in February 2023, the Wyoming House of Representatives declined to address a proposed Medicaid expansion bill.

Arguments Against Medicaid Expansion

In states without Medicaid expansion, those opposed to expanding coverage have voiced such concerns as increased costs and a higher risk of fraud.

For example, some argue that Medicaid expansion would burden their state’s budget. Although the federal government funds the majority of expanded Medicaid, it does not completely cover the costs; states pay 10 percent. In the case of Wyoming, House Majority Floor Leader Rep. Chip Neiman has raised concerns that the federal government would not uphold the federal match, leaving the state to bear more financial responsibility.

Others contend that Medicaid’s most vulnerable beneficiaries may face greater competition for resources, that other health care options are available to those in need, or that expansion may not ultimately translate into better long-term health outcomes.

How Older Adults Can Find Out if They Are Eligible for Medicaid Coverage

In states that have adopted expanded Medicaid, you may qualify if your household income lies below 133 percent of the federal poverty level, according to HealthCare.gov.

For older adults, most states provide Medicaid to those who receive Supplemental Security Income (SSI). To be eligible for SSI, individuals must have low incomes, limited assets, and be unable to work due to a qualifying mental or physical impairment. Per the Kaiser Family Foundation, some states expand Medicaid to older adults and disabled people whose income surpasses the SSI limit but falls below the federal poverty level.

You may be able to qualify for Medicaid through the Medically Needy program if your state has established one. The Medically Needy program allows people to enroll in Medicaid when they have significant medical expenses. When they subtract their medical spending from their total income, they can qualify for Medicaid if their income, minus health care expenses, falls below a specified limit (which also varies by state).

To find out whether you qualify for Medicaid, consider consulting the following tools:

• The Benefits.gov Eligibility Checker will ask you questions regarding things like household income, number of dependents, and citizenship status to help you determine whether you might be eligible for Medicaid generally.
• The HealthCare.gov site can offer additional insights, including:
  • Guidance on Health Insurance Marketplace applications
  • Income calculators
  • Premium tax credit information
  • Q&A tool to determine eligibility for cost-sharing reductions

Again, the rules governing Medicaid and its complex eligibility criteria varies widely by state. To find out whether you may be able to receive public health insurance through Medicaid, consult with your attorney.

This Tax Season, Seniors Can Get Free Assistance

When it comes to filing your 2022 federal tax return for the 2023 tax season, you may be able to access several forms of assistance for free.

Filing Online: IRS Free File

In January 2023, the Internal Revenue Service (IRS)’s Free File service opened to taxpayers. Through IRS Free File, you can prepare and file your federal individual tax online — at no cost to you.

The service is made possible by volunteers and enables you to file your taxes from your computer, smartphone, or tablet.

The product options available to you may vary based on such factors as your gross income, location, and number of dependents:

• If you are a taxpayer who made $73,000 or less in 2022, you may qualify for IRS Free File Guided Tax Preparation. This service assists you in preparing as well as filing your federal income tax return through an IRS partner site for free.
• Taxpayers who made more than $73,000 in 2022 may be interested in taking advantage of the IRS’ Free File Fillable Forms. These are digital federal tax forms that you can complete, sign, and file online at no cost

Do I Need to Apply for Free File?

You do not need to apply for Free File. Simply visit the IRS’s Free File Lookup Tool and answer a series of questions to find out what product(s) you may be eligible to use.

Learn more about each service on the IRS website.

In-Person Support: Saturday Walk-In Hours

For those who would prefer in-person help, the IRS will now also be offering special Saturday hours to aid taxpayers at locations across the country.

There is no need to schedule an appointment for these special hours; you can walk in to speak directly with an IRS employee.

When Will Special IRS Saturday Hours Be Held?

Special Saturday hours will be from 9 a.m. to 4 p.m. in many states — as well as Washington, D.C., and Puerto Rico — on the following dates:

• Saturday, February 11, 2023
• Saturday, March 11, 2023
• Saturday, April 8, 2023
• Saturday, May 13, 2023

Prior to visiting an IRS office offering this service, be sure to double-check the IRS website for details regarding its Saturday hours.

“These walk-in locations are critical, and funding from the Inflation Reduction Act is allowing us to add more employees across the nation to better assist taxpayers this filing season and beyond,” Acting IRS Commissioner Doug O’Connell said in an IRS news release. “These special Saturday hours will help people get the services they need.”

Find more information about locations offering special Saturday hours, what to expect during your visit, what documents you will need to bring, and more.

Volunteer Income Tax Assistance (VITA) Program

In addition, the IRS provides free assistance in tax return preparation for seniors, people with disabilities, taxpayers with annual income below $58,000, and taxpayers who are not fluent in English. It is called the Volunteer Income Tax Assistance (VITA) Program.

Where Is the VITA Program Available?

You can find a VITA office near you on the IRS website; search by your ZIP code.

TCE: Free Tax Preparation for Seniors

Seniors can also benefit from the Tax Counseling for the Elderly (TCE) Program, which is also free. If you a taxpayer who is aged 60 or older, you can connect throughout tax season with a volunteer who can help you prepare your tax return. Locate an office with this service near you.

When Is Tax Season, Exactly?

The 2023 tax season officially began January 23, 2023. This is the date on which the IRS begins processing tax returns from the 2022 tax year. Tax season ends each year in mid-April.

When Are Tax Returns Due for the 2023 Tax Season?

In most cases, you should file your individual income taxes for the 2022 tax year by April 18, 2023. Extensions are available in certain circumstances. If you request an extension, your deadline for filing is October 16, 2023.

Deducting Long-Term Care Insurance Premiums in 2023

Are you a taxpayer who has purchased long-term care insurance (LTCI)? Take note of your policy details and your premium amount, as you may be able to deduct the cost – or at least part of it – from your 2023 income.

If your total eligible medical expenses (including your LTCI policy premium) for the year exceed 7.5 percent of your adjusted gross income, you may be able to take the amount of your LTCI policy premium as a deduction on your federal income tax return.

However, note that only certain LTCI policies qualify.

What Is Long-Term Care Insurance, and Do I Need It?

Long-term care insurance helps you cover costs for services you will likely need as you grow older, such as nursing home care or home health care.

According to LongTermCare.gov, U.S. seniors aged 65 today face a nearly 70 percent chance of requiring some form of long-term care later in life. In fact, almost a fifth of them will need it for more than five years.

Policies for this type of insurance can vary dramatically. Most will provide you with between $2,000 and $10,000 in funds each month, with premiums costing up to $5,000 a year. The younger you are when you purchase LTCI, the less pricey your annual premiums will generally be.

Keep in mind, too, that the average prices for long-term care have skyrocketed over time. For example, a private room in a nursing home will currently cost you more than $9,000 a month on average.

Unless you have very significant wealth, paying for LTCI may be well worth the cost, given how quickly long-term care can drain your retirement savings.

Can I Deduct My Long-Term Care Insurance Premium?

As mentioned above, only certain LTCI policies are tax-deductible. If your LTCI policy is considered “qualified” for tax deductibility, your total eligible medical expenses (including your LTCI policy premium) for the year also need to exceed 7.5 percent of your adjusted gross income in order you to be able to deduct your premium.

In addition, you are limited in how large a premium you can deduct. Read more about these caveats below:

1. Tax-Qualified Policies– To qualify for tax deductibility, your LTCI policy is required to meet specific rules, as outlined by the National Association of Insurance Commissioners (NAIC).
   
   If you purchased your policy before January 1, 1997, it is likely qualified. (Double-check with your insurance broker or their state’s insurance commission.)
   
   Policies purchased on or after January 1, 1997, have to meet a number of federal standards. Learn more about these standards on Page 9 of theNAIC’s Shopper’s Guide to Long-Term Care Insurance, available in PDF format.
2. Deduction Limits– The limit on your deduction depends on your age at year’s end. The IRS annually issues adjustments to these limits; it increased the 2023 tax-deductible limits by about 6 percent since 2022.

Note that if your annual premium amount for 2023 exceeds the limit provided in the table that follows, it will not be considered a medical expense:

Attained age before the close of the taxable year	Maximum deduction
Age 40 or under	$480 (up from $450)
Age 41 to 50	$890 (up from $850)
Age 51 to 60	$1,790 (up from $1,690)
Age 61 to 70	$4,770 (up from $4,510)
Age 71 and over	$5,960 (up from $5,640)

 

3. Other Caveats

• If you are self-employed, you can take the amount of the policy premium as a deduction if you made a net profit. Your medical expenses do not necessarily need to have exceeded 7.5 percent of your income.
• Most hybrid life insurance policies are typically ineligible for tax deductions.
• Note as well that benefits from per diem or indemnity policies, which pay a predetermined amount each day, are not included in income except amounts that exceed the beneficiary’s total qualified long-term care expenses or $420 per day (for 2023), whichever is greater.

For further details on these and other inflation adjustments, access the complete PDF from the IRS website.

Additional Resources

To get an idea of how much long-term care may cost you, visit Genworth’s Cost of Care online tool to calculate the cost of care where you live.

Be sure to seek out information from your attorney when it comes to evaluating your long-term care insurance needs as well as protecting your loved ones’ assets in the event that you do require long-term care. 

How Medicaid's Money Follows the Person Program Aids Seniors

Congress established the Medicaid Money Follows the Person (MFP) Program to provide states with federal funding to help seniors who are receiving care in institutions but want to live at home.

However, it is not a permanent program and is due to expire in September 2027. Advocates have pushed for Congress to make MFP permanent, ensuring that states have funding for seniors who wish to return home from long-term care facilities.

What Is the Medicaid Money Follows the Pereson (MFP) Program?

MFP was established in 2005 to increase Medicaid enrollees’ access to home- and community-based services (HCBS). In part, its goal is to allow seniors to avoid nursing homes and other institutions, and instead receive care in their own homes and communities if they choose. Other beneficiaries of the program include people with disabilities.

MFP allows the Centers for Medicare and Medicaid Services to remove the restrictions that are placed on how funds are allocated for long-term services. It increases the use of HCBS services instead of long-term services and support.  

How Does MFP Help Older Adults?

Throughout its existence, MFP has helped seniors who otherwise would have been institutionalized maintain control over their lives by providing a chance at independent living. In the nearly two decades since the program began, MFP has helped more than 107,000 people move from a nursing home or a long-term care facility back into their home. One evaluation found that MFP results in greater life satisfaction among participants.

Returning home from an institution is a tall task for most seniors. A major concern is the lack of staff to take care of an individual’s medical and personal needs. In many cases, seniors must rely on family members. MFP helps ease the burden of transitioning from care facilities back home.

Examples of the type of support MFP provides seniors as they move back home typically include:

• Help paying for groceries
• Short-term transitional housing
• Security deposits for rental homes and apartments
• The cost of necessities for setting up a home (e.g., stair-lifts, wheelchair ramps)

Can MFP Help Seniors Secure Housing?

The federal government funds the Medicaid Money Follows the Person program. Medicaid is prohibited from paying for housing directly. MFP allows states to use money from the program to pay for case management and transitional support services for seniors.

To address the needs of low-income seniors, state governments have used MFP funds to partner with housing authorities and developers to ensure more housing options are available for seniors who want to live independently.

Will the Medicaid Money Follows the Person Program End?

MFP has been a Medicaid demonstration program since 2008. Demonstrations are used to determine whether programs should become permanent. More than 40 states and territories currently are a part of MFP.

However, Congress has inconsistently funded MFP. The uncertainty about whether the program will have long-term funding has made it difficult for states to budget, so over time some states have been opting out of the program entirely. If MFP expires in 2027, many more seniors will be forced to live in long-term care facilities, losing the independence they desire.

It remains to be seen whether Congress will make the program permanent. If it does, states will have a set amount of money to increase seniors’ ability to live on their own as they age.

Learn more about the program at Medicaid.gov. For further guidance, speak to your elder law attorney.