Fayette County, Kentucky vs Hillsborough County, Florida

Hospitals serving Fayette County — such as UK HealthCare, Baptist Health Lexington, and CHI Saint Joseph Lexington — must provide financial assistance (charity care) under federal law: every nonprofit hospital is required by IRS Section 501(r) to have a written Financial Assistance Policy. Uninsured and underinsured patients with limited income can get free or discounted care, and those who qualify are never charged more than the amounts generally billed to insured patients. Income limits vary by hospital (commonly up to 200-300% of the federal poverty level for full or partial relief). Ask the hospital's financial-counseling or billing office for its Financial Assistance Policy and application.

Estimated bill savings: $500–$20,000 a year

Kentucky operates five state veterans cemeteries — Kentucky Veterans Cemetery West, Central, North, North East, and South East. Burial services are free for the veteran: the gravesite, opening and closing of the grave, perpetual care, a headstone, a burial flag, and a Presidential Memorial Certificate all come at no cost. A spouse may also be buried for a $500 fee that is not owed until the time of death, and minor children and some unmarried adult dependent children may be eligible too. Any veteran whose discharge was not dishonorable can qualify, and Kentucky residency is not required. Filing the eligibility application ahead of time settles the paperwork before the family ever needs it.

The Traumatic Brain Injury Trust Fund helps Kentuckians who have a partial or total disability caused by an injury to the brain and who do not have other viable funding sources for the services they need. It is a payer of last resort — it covers services only when other benefits have been exhausted or don't cover them. There is no family income cap. Covered supports include case management, community residential services, structured day programs, psychological services, prevocational and supported-employment services, companion services, respite care, occupational therapy, and speech/language therapy. It does not cover institutionalization, hospitalization, medication, or legal/court costs. Benefits are capped at $15,000 per year and $60,000 over a lifetime (case management does not count toward the caps).

Estimated service value: $2,000–$15,000 a year

Lexington runs a network of senior centers (including the Lexington Senior Center, Charles Young Center, Bell House, and Eldercrafters) that offer a safe, low-cost place for older residents to take part in fitness, recreation, educational activities, and meals. Staff also provide information, assistance, advocacy, and brief counseling — including help finding utility assistance, food assistance, home health care, senior housing, transportation, and Medicare Part D or other insurance options. It is open to Lexington (Fayette County) residents who are at least 60 years old and independent in their personal care and safety.

The Hillsborough County Health Care Plan (HCHCP) is the county's safety-net health coverage program for uninsured, low-income adult residents. Unlike a hospital charity-care program (which only discounts a specific facility encounter), HCHCP is a real coverage plan: enrollees receive primary care, specialty care, outpatient treatment, hospitalization at contracted hospitals, behavioral health, durable medical equipment, and prescription assistance through HCHCP's network of providers. The program is funded primarily by the County's Indigent Health Care Surtax (a half-cent local sales tax dedicated to indigent health care) and serves as Hillsborough's safety net after the county's public hospital authority was restructured in 1997. To enroll, you must be a Hillsborough County resident, an adult 18 or older, ineligible for Medicaid or Medicare (or any other comprehensive insurance), and meet HCHCP's income and asset limits (typically at or below 100 percent of the Federal Poverty Level for full coverage, with sliding scale up to higher brackets). Note that because HCHCP requires you to be ineligible for Medicare, this program is principally for adults aged 18-64 — once you turn 65 and qualify for Medicare, HCHCP closes you out and routes you to Medicare with optional Medicare Savings Programs.

Estimated bill savings: $1,500–$18,000 a year

Florida gives veterans age 65 and older a discount on the property tax bill for their homestead when they have a permanent, combat-related, service-connected disability and were honorably discharged. The discount percentage equals the VA disability rating — a 70% rating means 70% off the ad valorem taxes on the home. This is one of the largest senior-specific veteran benefits in Florida. If the veteran dies, the discount carries over to a surviving spouse who keeps the home and does not remarry. Apply with the county property appraiser by March 1 using Form DR-501DV, the VA letter showing the percentage and the combat-related finding, proof of honorable discharge, and proof of age.

Estimated bill savings: $150–$3,000 a year

A Florida veteran with a service-connected, total and permanent disability pays NO property tax on the homestead — the home is fully exempt. The veteran must have been honorably discharged, and a letter from the VA certifying total and permanent disability is the proof. This is one of the largest dollar benefits available to Florida veterans. A surviving spouse who holds title, lives in the home, and does not remarry keeps the full exemption, and can transfer a fixed dollar amount to a new home after a sale. Apply once through the county property appraiser.

Estimated bill savings: $2,000–$5,000 a year

Florida exempts $5,000 of a disabled veteran's property value from taxation. It applies to an honorably discharged veteran who is a Florida resident and is disabled 10% or more from wartime service or by misfortune. The VA disability letter showing the rating counts as proof. An unremarried surviving spouse keeps the exemption. Apply once through the county property appraiser by March 1. This exemption stacks on top of the regular homestead exemption, and it is separate from the larger benefits for 100% disabled veterans and for combat-disabled veterans age 65 and older.

Estimated bill savings: $40–$50 a year

Florida homeowners with a homestead exemption can put off paying part of their property taxes when the bill is high compared with their income. If you are 65 or older, you can defer the part of your taxes and assessments that is more than 3% of your household income (5% if you are younger than 65). You can defer the whole bill if household income was under $10,000 last year, or if you are 65 or older and your income is under the limit for the senior additional homestead exemption. The taxes are not canceled. They become a lien on the home, earn interest (no more than 7%), and come due when the home is sold or is no longer your homestead; a surviving spouse who qualifies can keep the deferral. You must apply each year with your county Tax Collector by March 31 and keep fire and extended insurance on the home.