Supporting Older People’ Fundamental Wants: Well being Care, Revenue, Housing, and Meals

After working all their lives, many older adults in our communities can’t afford well being and long run care, battle to maintain a roof over their heads and meals on the desk, and don’t have sufficient money readily available to pay the utilities and get the place they should go.

A mixture of federal packages assist People meet these fundamental wants and thrive as they get older. These packages work collectively, forming an internet of help that’s vital to their success. For instance, with out assets to purchase wholesome meals, older adults with diabetes or coronary heart illness would jeopardize their well being. With out long-term companies and helps, many older adults wouldn’t be capable of afford to stay safely at residence. With out housing help, many older adults on mounted incomes must select between paying for hire or medication. Older adults whose solely earnings is from Supplemental Safety Revenue (SSI) wouldn’t be capable of afford groceries with out the Supplemental Vitamin Help Program (SNAP), or pay the hire with out rental help, or see the physician with out Medicaid.

Well being Packages That Assist the Entire Particular person

Everybody ought to have entry to reasonably priced, dependable well being care as they age. Medicare and Medicaid are necessary packages that work collectively to make sure older People get the care they should keep wholesome and unbiased.

Medicare

Medicare is a federal medical health insurance program that’s the main supply of protection for over 66 million older adults and other people with disabilities.^[1] Most individuals qualify primarily based on their work historical past or the work historical past of their partner. Some folks with out a work historical past pay privately to enroll or obtain premium help if they’re low earnings.

Regardless of offering important companies—corresponding to hospital care, physician’s visits, and prescriptions—Medicare leaves many individuals with vital out-of-pocket prices. Twenty-five p.c of Medicare enrollees have annual incomes under $21,000 per particular person and half have incomes under $36,000.^[2] They report spending on common $7,000 yearly on well being care—or about 14% of their complete family earnings.^[3] Whereas Medicare covers some restricted nursing facility, residence well being, and hospice care, it doesn’t cowl most long-term companies and helps. Medicare additionally doesn’t cowl dental, imaginative and prescient, or listening to aids. Due to these gaps in protection, most enrollees depend on supplemental insurance coverage (corresponding to a personal Medigap plan or retiree protection) or Medicaid.

Medicare has 4 “Components” which cowl hospital care, outpatient companies like physician’s visits, remedy and lab assessments, pharmaceuticals, medical gear, and medically needed transportation:^[4]

• Half A covers hospital care.
• Half B covers doctor and different outpatient companies.
• Half C is a program known as “Medicare Benefit” that delivers Components A and B, and typically D, protection via non-public well being plans.
• Half D is prescription drug protection.

Collectively, Components A and B are known as “Unique Medicare.” Every Half has premiums, deductibles and cost-sharing. People who find themselves eligible primarily based on work historical past don’t pay a premium for Half A, and other people with low-income might qualify for monetary help with Half A, Half B, and Half D premiums and out-of-pocket prices.

Medicaid

Medicaid is a joint federal-state program that gives well being and long-term care to individuals who in any other case couldn’t afford it. Medicaid covers over 7 million older adults age 65+ who’re additionally eligible for Medicare^[5] and 1 in 5 older adults ages 50-64.^[6] The federal authorities contributes funding and units the essential guidelines, however every state can alter eligibility standards and the advantages coated. States should supply Medicaid protection to sure classes of low-income folks, together with adults age 65 and older and other people with disabilities, however the guidelines for qualifying are stringent. Though the earnings and useful resource limits fluctuate by state and eligibility class, most individuals receiving Supplemental Safety Revenue (SSI) and/or State Supplemental Funds (SSP) are mechanically eligible resulting from their extraordinarily low incomes. States can also present protection to adults underneath age 65 via the Reasonably priced Care Act’s Medicaid growth and to folks with excessive well being care bills corresponding to long-term care (the “medically needy”).^[7] Medicaid additionally makes Medicare extra reasonably priced by paying for Medicare out-of-pocket via Medicare Financial savings Packages. With very restricted exceptions, states can’t cost premiums or copayments for Medicaid companies.

Medicaid covers over 7 million older adults who’re additionally eligible for Medicare and 1 in 5 older adults age 50-64.

Medicaid House and Neighborhood-Primarily based Providers (HCBS)

Most of us will want some type of help as we age, whether or not at residence or in a facility. Medicaid is the first payer of long-term care in nursing services, funding look after over sixty p.c of individuals in nursing properties.^[13] Medicaid additionally helps independence for many who can age at residence with helps by offering residence care if state packages select to offer this selection.

These companies, known as residence and community-based companies (HCBS), allow older adults and other people with disabilities to obtain care and companies of their properties and communities reasonably than being compelled to maneuver into an establishment.^[14] These companies embody private care companies corresponding to assist with consuming and bathing, transportation to medical or different appointments, and serving to with meal preparation and housekeeping. All states present Medicaid HCBS with protection various significantly from state to state with lengthy waitlists for companies in some states.^[15]

Nearly half of older adults dwelling locally want help with their very own care or taking good care of their properties.

Monetary eligibility requirements are barely larger for these eligible to obtain long-term companies and helps, together with in-home care, than for different Medicaid protection typically.^[16] Nonetheless, these receiving long-term companies and helps via Medicaid sometimes pay most of their earnings to the Medicaid program. Those that depend on Medicaid HCBS are often capable of retain a few of their earnings to pay for housing and different bills. For married {couples}, when one partner wants long-term care and the opposite one doesn’t, federal Medicaid legislation gives protections that make sure the partner not needing these companies can retain sufficient of the couple’s joint earnings and financial savings to remain out of poverty.^[17]

As we age and our wants and bills change, having a secure earnings to afford housing, medication, meals, and transportation is crucial. Advantages offered as a part of the Social Safety system, administered by the Social Safety Administration, maintain tens of millions of older People out of poverty.

Social Safety Advantages

Social Safety is a trusted program that displays American values of arduous work, equity, and dignity. Employees pay into all of it their lives with the promise that, after they can now not work, that cash shall be there to assist them meet their fundamental wants.^[18] Social Safety advantages carry over 15 million older People out of poverty every year and supply a basis of retirement safety for folks in any respect earnings ranges. Social Safety is environment friendly to manage as a result of its advantages aren’t means-tested, which means advantages aren’t lowered or denied to folks whose earnings or property exceed a sure stage, and participation is common.

With out Social Safety, an estimated 40% of older People would have incomes under the poverty line and can be unable to pay for fundamental requirements.

Social Safety gives a common earned money profit that protects People from poverty as they age. Social Safety contains retirement (“previous age”) advantages, survivor advantages, incapacity advantages, and advantages for dependents of retired or disabled staff. With out it, an estimated 40% of older People 65+ would have incomes under the poverty line, and can be unable to pay for fundamental requirements corresponding to meals, housing, clothes, and medication. Along with retirement advantages, staff additionally earn life insurance coverage and incapacity insurance coverage safety, which permits eligible relations to obtain earnings when a working member of the family dies, and helps individuals who can’t work due to extreme and long-lasting disabilities. About 80% of beneficiaries are older adults.^[19]

Social Safety advantages are modest in comparison with the price of dwelling; the typical Social Safety retirement profit in January 2025 was $1,837 a month, or a bit over $22,000 a 12 months. To calculate a person’s profit quantity, the Social Safety Administration (SSA) makes use of a person’s month-to-month earnings for every of the 35 years through which the person earned essentially the most. SSA then applies a method to those earnings to reach at a fundamental month-to-month profit quantity. The quantity folks obtain when their advantages start units the bottom for the quantity they’ll obtain for the remainder of their lives. A person can select to start receiving common retirement advantages at full retirement age,^[20] lowered retirement advantages beginning at 62, or elevated retirement advantages as much as 70. As soon as somebody begins receiving Social Safety, their advantages are adjusted to maintain tempo with inflation, serving to to make sure that folks don’t fall into poverty as they age.

Supplemental Safety Revenue (SSI)

As People age and earnings inequality continues to rise, Supplemental Safety Revenue (SSI) is extra necessary than ever. SSI is a federal program that gives a restricted earnings for over 8 million individuals who can now not work to satisfy their fundamental wants, together with 2.4 million older adults and other people with disabilities.^[21] Many labored however earned low wages and want each SSI and Social Safety to outlive. Greater than 1.2 million older adults receiving SSI earned sufficient credit for his or her work to qualify them for a modest Social Safety profit. They might have earned low, irregular wages, or frolicked off work caring for household. Girls make up the vast majority of older adults receiving SSI—or 64%—as a result of they’re extra prone to have frolicked out of labor caring for household, to have labored low-wage or part-time jobs, or in jobs the place they didn’t obtain Social Safety credit.^[22]

For very low-income older adults who obtain SSI, the typical good thing about $590 per thirty days means many nonetheless stay under the poverty line.^[23] However with out SSI, they’d be dwelling in deep poverty. Whereas SSI serves as a lifeline for older adults, it additionally helps strengthen our communities: SSI advantages forestall homelessness by paying for hire, utilities, property taxes, and supply dependable earnings to safe a lease. SSI additionally boosts native economies as SSI {dollars} help native companies and important companies.

Girls make up the vast majority of older adults receiving SSI as a result of they’re extra prone to have frolicked out of labor caring for household, to have labored low-wage or part-time jobs, or in jobs the place they didn’t obtain Social Safety credit.

Regardless of its significance in addressing deep poverty, many SSI guidelines haven’t been up to date in 40 years. Financial savings penalties, or asset limits, forestall a recipient from saving greater than $2,000 ($3,000 for {couples}).^[24] Surpassing this restrict by even $1 discontinues advantages, making it unattainable to arrange for emergencies like a automotive restore or new roof. Different earnings restrictions forestall folks from lifting themselves out of poverty: receiving simply $20 per thirty days from different sources like Social Safety reduces SSI advantages dollar-for-dollar, and incomes greater than $65 per thirty days from work decreases advantages, discouraging work for many who can contribute.

Housing And Meals Assist Older Adults’ Each day Lives

All of us deserve entry to reasonably priced housing and the steadiness, independence, and safety it gives as we age. Housing packages present help to round 2.1 million older adults,^[25] whereas vitamin packages be certain that over 4.8 million low-income older adults wouldn’t have to decide on between meals and paying the hire or shopping for garments or medication.^[26]

Reasonably priced Housing and Homeless Help

Federal housing and homeless help packages present very important help to many low-income older adults who would in any other case be unable to afford the price of shelter. Of the ten million households receiving federal rental help, about 21% are an older grownup (outlined as 62 years of age or older).^[27]

The U.S. Division of Housing and City Improvement (HUD) administers most federal rental help packages.^[28] Some main federal packages that present rental help for households across the nation, together with households with older adults, embody Housing Selection Vouchers (generally known as “Part 8” Vouchers), Public Housing, and multifamily housing like Part 202 housing for older adults. HUD homeless help packages additionally supply rental help.^[29]

Housing Selection Vouchers assist folks pay hire within the non-public housing market, requiring them to pay solely a set portion of their earnings, with the voucher overlaying the remaining price as much as a specified restrict. The Housing Selection Voucher program is the biggest federal rental help program and helps greater than 800,000 older adults.^[30]

Public Housing is mostly owned and operated by native public housing authorities. The price of hire can be primarily based on a family’s earnings. Public housing serves about 330,000 older adults, and the typical age of public housing residents is 52 years.^[31]

Part 202 Supportive “Senior” Housing particularly helps low-income older adults 62 years of age or older.^[32] Older People dwelling in Part 202 housing even have entry to community-based companies and helps to assist them keep of their properties and age in place in their very own group. About 16% of Part 202 residents are age 85 or older, and in 2023, Part 202 tenants had a median annual family earnings of simply over $15,000. Roughly 123,000 households with older adults acquired help via the Part 202 program in 2023.^[33]

HUD Homeless Help Packages present entry to interventions, corresponding to shelters and everlasting supportive housing (PSH), for folks vulnerable to or experiencing homelessness. PSH provides rental help with voluntary companies for folks with disabilities who want extra help to realize housing stability.

The Low-Revenue House Vitality Help (LIHEAP) Program, whereas not thought-about a housing help program, helps older adults keep of their properties by serving to households afford residence heating and cooling.^[34] It additionally might present funds to make folks’s properties extra power environment friendly, thereby lowering heating and cooling prices. As a result of these prices may be fairly excessive, LIHEAP is a vital technique of help for older adults who would in any other case be unable to pay for warmth or air-con throughout harsh climate.

Older People Act Packages

The Older People Act (OAA) is a cornerstone of help for older adults, funding important companies that assist practically 11 million older adults and their household caregivers—particularly these with low incomes or vulnerable to isolation—preserve their freedom, well being, and dignity. OAA packages cut back starvation, isolation, and obstacles to care: transportation companies assist older adults who stay alone and would in any other case be homebound to entry their docs’ places of work, pharmacies, and meal websites; and Meals on Wheels and different vitamin packages feed over two million older adults, guaranteeing they keep wholesome and reducing their threat of incapacity. OAA packages maintain older adults and communities by offering companies like in-home help, grownup day care, caregiver respite, entry to authorized help, elder justice and elder abuse prevention, case administration and care coordination companies, illness prevention, job coaching, and group service packages, and lots of others.^[35]

Vitamin Help

Older People in our communities ought to by no means face the unattainable alternative of paying for meals or different requirements like medication and shelter.^[36] Additional, analysis from the group Feeding America discovered that meals insecure adults “are 53% extra prone to report a coronary heart assault, 52% extra prone to develop bronchial asthma, and 40% extra prone to report an expertise of congestive coronary heart failure.”^[37] Packages like SNAP and Meals on Wheels immediately fight starvation amongst older adults and reduce well being care prices by reducing hospitalization charges and nursing residence admissions.^[38]

Packages like SNAP and Meals on Wheels immediately fight starvation amongst older adults and reduce well being care prices by reducing hospitalization charges and nursing residence admissions.

Supplemental Vitamin Help Program (SNAP) is a federal program that ensures that over 4.8 million low-income older adults don’t go hungry.^[39] SNAP gives modest advantages that help native economies and jobs as advantages are spent locally, and SNAP allows tens of millions of older adults to afford wholesome meals, whereas nonetheless having the ability to pay for necessities like well being care and housing.^[40] The typical SNAP profit for households with an individual over 60 years previous was $158 per thirty days in 2022.^[41]

Meals on Wheels combats social isolation and starvation whereas ensuing the well being and security of older adults dwelling at residence. It gives greater than 2 million older adults with home-delivered nutritious meals, social visits, and checks to make sure that they’re protected of their properties. Meals on Wheels additionally gives meals in group settings like senior facilities. OAA funds cowl a couple of third of the entire price of offering meals via Meals on Wheels, whereas state and native funds and personal donations cowl the remaining.^[42]

Authorized Help

Authorized help is essential to serving to low-income older adults stay safely, entry the packages and helps they want, and keep away from or escape deep poverty. Authorized assistance is vital for low-income older adults who’re denied wanted well being care, vulnerable to dropping their housing via eviction or foreclosures, dealing with pointless guardianship, or who’re impacted by elder abuse, shopper scams, or monetary exploitation. Additional, authorized companies may also assist older adults entry packages for which they’re eligible, like SSI, Medicaid, and SNAP.

Almost three-quarters of low-income older grownup households had not less than one civil authorized drawback previously 12 months, and just one in 5 low-income older adults sought the assistance of a authorized skilled for his or her issues.^[43] Additional, low-income older adults obtain insufficient or no authorized assist for practically 9 out of 10 of the civil authorized issues they face in a given 12 months. Sturdy funding and help for authorized help packages can construct capability to meet this unmet want for older adults.

The Authorized Providers Company (LSC) is an unbiased group established by Congress that helps civil authorized support organizations throughout the nation. LSC ensures that older adults and households who can’t afford a lawyer nonetheless have entry to justice in civil authorized issues. LSC packages present authorized help to low-income People grappling with civil authorized points regarding important human wants corresponding to protected housing, entry to well being care, safeguards towards monetary exploitation, and help with household points corresponding to safety from abusive relationships. Roughly 7.6 million older adults stay in households with earnings under 125% of the Federal Poverty Degree, the earnings eligibility customary for folks looking for help from an LSC-funded authorized support program.^[44]

Title IIIB of the Older People Act additionally funds a spread of supportive companies together with authorized companies. Over 1,000 authorized companies suppliers obtain OAA funding that seeks to help older adults with the best social and financial wants. Title IIIB legal professionals present practically a million hours of authorized help every year, serving to older adults keep unbiased and wholesome, defending towards eviction, starvation, fraud, or abuse, and serving to them keep of their properties and communities for so long as potential.

Conclusion

When correctly funded and supported, the packages outlined above work collectively to make sure that older adults can entry meals, shelter, well being care, and medication. Packages that be certain that everybody can meet their fundamental wants mirror core American values of dignity, self-determination, and group. As extra of us stay longer and retire with fewer assets than earlier generations, sustaining and funding a strong set of group companies and helps is extra necessary than ever. Older adults are the spine of our households and communities, and after they thrive, all of us thrive. By understanding how these packages work collectively, we will shield and enhance them, guaranteeing that everybody has the help they want as they get older.

Endnotes

1. Kaiser Household Basis, Medicare 101 (Might 28, 2024. ↑

2. Kaiser Household Basis, “Revenue and Property of Medicare Beneficiaries in 2023” (Feb. 5, 2024. ↑

3. Kaiser Household Basis, Medicare Households Spend Extra on Well being Care than Different Households (Mar. 14, 2024). ↑

4. Justice in Ageing, Authorized Fundamentals: Medicare Components A, B, and C—Eligibility and Enrollment (January 2017). ↑

5. Facilities for Medicare & Medicaid Providers, Seniors and Medicare and Medicaid Enrollees (final accessed Feb. 18, 2025). ↑

6. AARP, Medicaid in Midlife: A Profile of Enrollees 50-64 (Might 2023). ↑

7. Nationwide Middle on Regulation & Elder Rights, Authorized Fundamentals: Medicaid 101 (March 2021). ↑

8. Facilities for Medicare and Medicaid Providers, Listing of Medicaid Advantages, (final accessed Feb. 18, 2025). ↑

9. Facilities for Medicare & Medicaid Providers, Seniors & Medicare and Medicaid Enrollees (final accessed Feb. 18, 2024). Kaiser Household Basis, A Profile of Medicare-Medicaid Enrollees (Jan. 31, 2023). ↑

10. Nationwide Middle on Regulation & Elder Rights, Authorized Fundamentals: Medicare Financial savings Packages (Sept. 2024). ↑

11. Medicare Fee Advisory Fee; Medicaid Fee Advisory Fee, Knowledge E book: Beneficiaries Dually Eligible for Medicare and Medicaid (Jan. 2024). ↑

12. Justice in Ageing, Twin Eligible Particular Wants Plans (D-SNPs): What Advocates Have to Know (Feb. 28, 2024). ↑

13. Kaiser Household Basis, A Have a look at Nursing Facility Traits (Dec. 6 2024). ↑

14. Justice in Ageing, Medicaid House and Neighborhood-Primarily based Providers for Older Adults with Disabilities: A Primer (April 2021). ↑

15. Kaiser Household Basis, What’s Medicaid House Care (HCBS) (Feb. 18, 2025). ↑

16. Kaiser Household Basis, What are the Main Medicaid Eligibility Pathways for Twin-Eligible People? (Oct. 22, 2024). ↑

17. Nationwide Middle on Regulation & Elder Rights, Authorized Fundamentals: Medicaid 101 (March 2021). ↑

18. Middle on Price range and Coverage Priorities, Social Safety Lifts Extra Individuals Above the Poverty Line than Another Program (January, 2025). ↑

19. Social Safety Administration, Quick Details & Figures About Social Safety, 2024. ↑

20. Beforehand 65 years previous. For these born in 1938 and later, the total retirement age is regularly growing to 67 years previous. ↑

21. Social Safety Administration, Quick Details & Figures About Social Safety, 2024 (September 2024). ↑

22. Social Safety Administration, Annual Statistical Complement to the Social Safety Bulletin, 2024 (December 2024), Desk 7.A9, Variety of recipients of federally administered funds, by eligibility class and age, December 1974-2023. ↑

23. Social Safety Administration, Month-to-month Statistical Snapshot (February 2025). ↑

24. Supra word 21. ↑

25. Middle on Price range and Coverage Priorities, Federal Rental Help Reality Sheets (January 2025). ↑

26. SNAP and Senior Starvation Details. ↑

27. Middle of Price range & Coverage Priorities, Reality Sheet: Federal Rental Help (Mar. 30, 2017). ↑

28. The U.S. Division of Agriculture additionally administers the agricultural rental help program (Part 521). ↑

29. Congressional Price range Workplace, Federal Housing Help for Low-Revenue Households (September 2015). ↑

30. Middle on Price range and Coverage Priorities, Coverage Fundamentals: The Housing Selection Voucher Program (September 2024). ↑

31. City Institute, The Way forward for Public Housing: Particular Points Going through Older Adults and Individuals with Disabilities (July 2022). ↑

32. Sofa, Linda, Part 202: Supportive Housing for the Aged. ↑

33. HUD, FY 2024 Congressional Justifications for Housing for the Aged (Part 202). ↑

34. Workplace of Neighborhood Providers, Workplace of Administration for Youngsters and Households, Low Revenue House Vitality Help Program. ↑

35. Older People Act, 42 U.S.C.§3021 et seq. (2016). ↑

36. Siliak, James P. and Gundersen, Craig, Meals Insecurity Amongst Older Adults (August 2011). ↑

37. Feeding America & Nat’l Basis to Finish Senior Starvation, Highlight On Senior Well being: Adversarial Well being Outcomes of Meals Insecure Older People. ↑

38. Szanton, Sarah L., et. al., Meals help is related to decreased nursing residence admissions for Maryland’s dually eligible older adults. Samuel, Laura, et. al., Does the Supplemental Vitamin Help Program Have an effect on Hospital Utilization Amongst Older Adults?. ↑

39. Nationwide Council on Ageing, 7 Details About Older Adults and SNAP (April 2024). ↑

40. United States Division of Agriculture, Traits of Supplemental Vitamin Help Program Households: Fiscal 12 months 2022. ↑

41. Supra word 39. ↑

42. Meals on Wheels, 2025 Nationwide Snapshot Reality Sheets. ↑

43. Authorized Providers Company, Snapshot of Key Findings for Seniors (2021). ↑

44. Id. ↑