Private pay options involve using personal income or assets to pay for services and supports. Private pay, which is also called “out-of-pocket payment,” can be for service either in the home or as part of residential care. Private pay options include using a reverse mortgage or long-term care insurance as well as “spending down” assets to qualify for Medicaid. Private pay means that there is no governmental program providing coverage. When coverage from insurance and other sources does not pay for your care in full, you generally have to pay the difference “out-of-pocket.” Be sure you understand in advance what your share of the costs will be.