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Once a senior or a person with disabilities decides that aging-in-place is the right option for them, the next natural question is, “How am I going to pay for the home modifications that will allow me to age-in-place comfortably, safely, and independently.”

A recent article by Lisa Ann Fagan, MS, OTR/L, and Cheri Cabrera, OTR, for the National Association of Home Builders (NAHB) offers some advice and perhaps even an answer to this question. According to the authors, while the need for home modifications is vast, many individuals who could benefit from these services are unable to afford them. In fact, approximately 80% of home modifications, renovations, and repairs are paid for by the primary occupants of the residence—of these the majority are funded by personal savings.

Other options for homeowners include a second mortgage and using the equity in their home to secure the loan. If the homeowner is over 62 years of age, a reverse mortgage may also provide financial resources to pay for the modifications.

The authors add that the remaining 20% of home modifications and home repairs are covered by a variety of programs and services. “Some of the options are restricted by age or disability, others are limited to individuals who reside in certain geographic locations, and yet others are reserved for individuals who meet strict income/resource criteria.”

Some of these programs are comprehensive in nature, offering home assessments, providing the renovations and/or equipment, and training the individual to use the modifications at little to no cost—while others offer only portions of these services.

The following list provided by the article is a comprehensive, but not all-inclusive, overview of potential funding sources for home modifications. The authors note that not all programs are available in all areas or to all potential recipients.

Insurance Coverage of Home Modifications

In some cases, automobile insurance policies, worker’s compensation programs, state catastrophic accident insurance plans, medical trust funds, or other insurance programs will pay for home modifications—particularly if the need for home modifications arose as the result of an accident or injury. These plans often provide payment for the evaluation by an occupational therapist, and the equipment and/or structural modifications needed to promote independence and safety.

Some older adults may also be able to access benefits from their long term care policy. Many policies will allow the beneficiary to use a specified amount of benefit dollars to pay for home modifications in lieu of admission to an assisted living facility or skilled nursing facility.

Individuals who are enrolled in Medicare and have a decline in functional status may qualify for an occupational therapy evaluation and treatment under the Medicare Outpatient (Part B) benefit. Medicare will pay for the occupational therapy evaluation and training in the use of the modifications, if ordered by a physician.

Medicaid programs vary by state, but some states offer Home and Community Based Services (HCBS) through a waiver program. The waiver programs permit states to use Medicaid funds for services as an alternative to institutional care. Home modifications are one of the services offered by many states under the waiver program.

Federal Programs Administered at the State or Local Level

Some Area Agencies on Aging may offer home modifications as part of the services that are provided. Depending on the area in which the individual resides, the program may offer home repair and modification services on a sliding scale or free of charge.

The U.S. Department of Housing and Urban Development (HUD) awards Community Block Development Grants (CBDG) to eligible city and county housing and community development departments to revitalize neighborhoods and improve community facilities and services. Many communities choose to provide home modification programs with part of their CBDG funds.

The U.S. Department of Agriculture has created the Rural Development Home Repair Loan and Grant Programs to provide assistance to individuals who live in areas with a population fewer than 10,000. This program provides low-interest loans to homeowners of all ages, and grants to individuals over age 62 who meet specified income criteria, to assist with home repairs and making homes accessible for people with disabilities.

For individuals who have served in the military and have specific service-related disabilities, the U.S. Department of Veterans Affairs (VA) offers the Specially Adapted Housing Grants Program. In addition, veterans may qualify for a VA Home Loan that can be used to simultaneously purchase and modify a home.

State Assistive Technology (AT) Projects

Several states have initiated home modification programs through their statewide AT program. These programs can provide trial equipment as well as low-interest loans for the purchase of assistive technology or home modifications for individuals with disabilities.

Health Promotion / Fall and Injury Prevention Grants

Many local programs are providing information and referrals for home modifications as a strategy to reduce falls. A few programs will cover the cost of minor repairs or modifications.

Foundations and Organizations

For individuals who have been diagnosed with disabilities and conditions like Alzheimer’s disease, multiple sclerosis, or rheumatoid arthritis, there are several national nonprofit organizations (such as Easter Seals) with local chapters that may offer home modification funding or services to ease the burden of providing care in the home.

Another organization that provides home modifications and repairs is Rebuilding Together (RT). This group offers home repairs and modification at no cost to the homeowner. Using a volunteer team of unskilled and skilled tradespeople, RT has rehabilitated over one million homes nationwide!

Tax Deductions

If individuals did pay for the home modifications out of their personal savings, they may be eligible for Internal Revenue Service (IRS) deductions for medical expenses. While this mechanism does not provide funding for the modifications, it does provide a bit of financial relief for individuals in the form of lowered tax liability.

This is a brief overview of several, but not all, of the programs that fund home modification services. Many of the programs listed here offer services that may be provided directly through the state departments of health and human services/welfare, through centers for independent living, or under contract through other community agencies. In addition, agencies such as these often refer and contract local remodelers like Home Evolutions to complete the work necessary for your aging-in-place success.