The federal and state governments offer funding for providing
accessibility after a natural disaster or man-made catastrophic event
such as Hurricane Katrina or 9/11. Details on designated disaster areas
can be located at:
http://www.fema.gov/news/disasters.fema.
Many churches and religious organizations make funds available for catastrophic medical assistance.
Many cities and towns make grant funds available through the local department of community development.
Home adaptations and modifications of special needs may be coordinated
through government programs or home modification service organizations
such as Rebuilding Together (local chapters across the US).
Some private insurance will pay for durable medical equipment. Check your policy for coverage details.
Medicare does not pay for ramps. However, Medicare has paid for the
shower and lift products in certain situations. To find out more
information on whether Medicare will help to cover the expense of a
home modification (except ramps) ordered by a physician, call
1-800-MEDICARE (1-800-633-4227) or visit their website at
http://www.medicare.gov.
Medicaid waivers in some states, state child health insurance programs
(CHIP), private health insurance, workers' compensation and long-term
care insurance benefits may cover the ramps, showers and lifts. The
social service department of your hospital may be able to direct you to
the special discretionary funds through private charities or endowments
in your area.
Suggestion: Ask your attending physician to provide a
prescription or document of medical necessity for a ramp, shower or
lift product and submit a copy with your insurance claim.
The Internal Revenue Service reports allowable medical deductions for
amounts paid for special equipment installed in the home. Reasonable
costs to accommodate a home to a disabled condition are considered
medical care and are deductible on federal income tax returns. IRS
Publication 502-Medical and Dental Expenses
A prescription or document of medical necessity from an
attending physician would be prudent to keep in a personal file, in the
event of a question or audit by the IRS.
Taxpayers needing to fund large and ongoing medical expenses will also
be interested in exploring tax-advantaged ways to pay these expenses
beyond deducting them under the 7.5% of adjusted-gross-income
threshold.
Examples of potential alternatives include funding via Sec.
125 "cafeteria plans," health reimbursement arrangements (HRAs), IRA
and/or Sec. 401(k) withdrawals and medical savings accounts (Archer
MSAs).
Sec. 125 cafeteria plans are by far the most common tax-advantaged
medical expense reimbursement arrangements (after actual medical
insurance). Flexible spending accounts (FSAs) are funded by employee
contributions on a pre-tax salary-reduction basis to provide coverage
for specified expenses (e.g., qualified medical expenses or dependent
care assistance costs) incurred during the coverage period.
Reimbursement is subject to reasonable conditions, including a maximum
salary-reduction amount that may be set by the plan's terms.
Participants must use the FSA amounts for the specified expenses or
forfeit any amounts remaining as of the plan year-end; see, generally,
Prop Regs. Sec. 1.125-1.
Actually obtaining reimbursement may be
problematic; as a practical matter, participants regularly report
problems in convincing plan administrators that expenses (such as
special school tuition and fees) are legitimate medical expenses
properly reimbursable by the plan. Also, reimbursements actually
available are frequently less than the total actual medical expense,
due to employee-mandated limits on FSA funding.
Another alternative may be an HRA, which is an employee benefit plan
intended to reimburse employees for medical expenses not covered by
other insurance. In general, HRAs are funded by the employer, without
employee salary reductions, to reimburse an employee for substantiated
medical care expenses incurred by the employee and his or her spouse
and dependents. HRAs typically provide reimbursement up to a maximum
dollar amount for a coverage period, and may provide for carry forward
of any unused amount.
IRA and/or Sec. 401(k) withdrawals and medical savings
accounts (Archer MSAs). Early IRA withdrawals are penalty-free for
payment of excessive unreimbursed medical expenses.
Consult with a tax professional for further information.
Home modification and repair funds from Title III of the Older
Americans Act are distributed by your local area agency on aging. Call
the US Administration on Aging's Eldercare Locator (1-800-677-1116) or
visit the Eldercare Locator website at
http://www.eldercare.gov.
Home Repair Loan and Grant Program (Section 504).
For very low-income families who own homes in need of repair, the Home
Repair Loan and Grant Program offers loans and grants for renovation.
The Home Repair Program also provides funds to make a home accessible
to someone with disabilities.
Homeowners 62 years and older are eligible for home improvement
grants. Other low income families and individuals receive loans at a 1%
interest rate directly from HCFP.
