Financing Home Access

Home access upgrades and remodels can be pricey. What are some options?

Financing is a crucial part of home access. While many of the DME products and home upgrades that comprise home access services are essentially retail transactions, rather than funded through Medicare funding or private payor insurance, many home access upgrades can get expensive. Remodeling, retrofitting and reconstruction projects do not come cheap, with construction costs as much as 12 percent higher for an accessible homeas a standard home. Many patients need financing. Fortunately, there are options.

One choice would be a 203(k) loan. The Federal Housing Administration created the 203(k) loan program specifically to help homebuyers rehabilitate homes they wish to purchase to live in, but that are in disrepair. A 203(k) loan lets a qualified borrower not only finance the purchase price of the home, but also include the price of the necessary repairs to the home. And this includes home access upgrades.

There are two types of 203(k) loans, and the one that is right for your intended property depends on how much work needs to be done:

  • A “streamlined” 203(k) loan is intended for a home that requires only non-structural repairs.
  • A “regular” 203(k) loan is for properties that require structural repair, such as replacing the roof or a load-bearing wall.

A streamlined 203(k) provides up to $35,000 that can be added to the loan to cover the improvements, in addition to the purchase price of the home. For a regular 203(k), the homeowner can borrow the purchase price of the home, plus the price of the improvements, up to 110 percent of the home’s expected value after the improvements.

The money for the improvements is actually put into an escrow account that is used to pay for materials and the companies being contracted to do the home access work, such as the provider and its partners. Construction must begin within 30 days of the close of the loan and your work must be completed within six months. To ensure the patient still has a place to live, borrowers can finance up to six months’ mortgage payments in a 203(k) loan.

Moreover, it is important to note that many patients that need serious home access overhauls do not necessarily have the income to pay for such major projects. According to some studies, as many as one third of disabled patients live at or below the poverty line and might not qualify for home loans. In this case, there are special loan programs and other forms of funding that can help them attain the home access services the need.

The Fannie Mae Community HomeChoice is available to patients living on their own or someone living with a disabled family member to help them purchase an accessible home, or upgrade their existing home for home access. The loan is designed specifically for borrowers with low to moderate incomes, and offers fl exibility in terms of loan-to-value ratios, down payment sources, qualifying ratios and the establishment of credit.

Another option would be state-level loan programs. Nearly every state in the unions has created loan programs to help lower income borrowers with disabilities tap into lending options that offer very agreeable terms at rates and terms well below traditional home loans. Many do this by providing tax-exempt mortgage revenue bonds to local lenders, who then work with the patients needing financing. Make sure to study the programs offered by the state housing finance agencies and development agenciesfor the states where you provide services.

Additionally, there are special grants and other programs outside of true financing solutions. For instance, the Department of Veterans Affairs (VA) offers its Home Improvement and Structural Alterations and Special Home Adaptations grants for disabled veterans. Many state Medicaid programs offer home and community-based waivers that can help fund accessibility modifications.

Certainly, providers offering home access services should strive to have an inside-and-out knowledge of local, state and national lending programs from commercial and government sources that are geared toward helping patients finance their home access modifications and construction. But they should go the extra step and partner up with local lending professionals who can specialize in helping borrowers in need of home access financing solutions. (Loans such as 203(k) loans require much specialized knowledge, for instance.) These partners will not only help their patients and help generate the funding necessary to drive a home access project, but they can also become key referral partners that will use their marketing resources and their reputation to help drive business back to the provider.

This article originally appeared in the March 2012 issue of HME Business.

About the Author

David Kopf is the Publisher HME Business, DME Pharmacy and Mobility Management magazines. He was Executive Editor of HME Business and DME Pharmacy from 2008 to 2023. Follow him on LinkedIn at and on Twitter at @postacutenews.

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