How Do You Pay for a Nursing Home?

As the population ages, more and more people are facing the question: “How do I pay for a nursing home?” There are several ways to pay for the expenses associated with nursing homes and assisted living facilities. Typically, the options are to pay for nursing home care with one or more of the following:

  • Private Health Insurance and Long-term Care Insurance
  • Veterans Administration Aid and Attendance
  • Medicare and Medicare Supplement Policies
  • Medicaid and
  • Personal Resources

Paying for a Nursing Home: Long-Term Care Insurance

Experts estimate more than two-thirds of all people 65 and older will require long-term care services at some point in their lifetime.  Many employers offer long-term care insurance.  Additionally, long-term care insurance can be purchased privately.  These policies can cover both skilled and non-skilled care.  Policies vary, and while not all policies cover nursing home care, some do and some also include medical equipment, home care, adult day care, or assisted living.

Paying for a Nursing Home: Veterans Administration Aid and Attendance

Veterans may qualify for an increased pension amount if they are a patient in a nursing home care facility due to a mental or physical incapacity.  Additionally, survivors who are eligible for survivor’s benefits may also qualify for an increased pension amount if they are in a nursing home.  This increased pension amount should cover some, if not all, nursing home-related costs.

Paying for a Nursing Home: Medicare

Medicare does not cover long-term care, but it does cover rehabilitation. Consequently, if someone needs convalescent care after a minimum three-day hospital stay, Medicare will cover up to 100 days in a qualified nursing home. Additionally, relying on Medicare can help delay the need for a long-term care nursing home or assisted living facility. This is accomplished by providing up to 35 hours of home health services per week. This care covers occupational therapy, speech and language pathology, physical therapy, and intermittent skilled nursing care. This care is referred to as an “episode of care” and may be provided for up to 60 days at a time.

Medicare will also cover certain additional services needed while in a nursing home.  For example, Medicare covers hospital care, medical supplies, and doctor’s care while in a nursing home.  Additionally, Medicare Part D may cover some prescription drugs.

Paying for a Nursing Home: Medicaid

Medicaid will pay for nursing home care when someone has minimal assets.  The government has strict guidelines regarding the amount of cash and cash equivalents a person can have, including savings accounts, IRA accounts and bonds, and still qualify for assistance.  Applicants may have additional assets as long as they meet certain requirements.

Paying for a Nursing Home: Personal Resources

If Medicare, Veterans’ benefits, and long-term care insurance do not provide coverage, there is an expectation that personal resources will be used to pay for nursing home care or assisted living.  Some insurance companies permit using a life insurance policy to pay for long-term care.

A word of caution: some people think if they give their savings, their homes, or their other assets to their children, Medicaid will cover nursing home or assisted living expenses.  However, if assets are given to an adult child or another individual within five years of needing nursing home assistance, Medicaid may deny coverage, even though the assets are no longer in their name.

Assisted living facilities and nursing homes may be willing to negotiate rates.  It is not uncommon for those with personal resources to be able to negotiate a lower than advertised rate, however, this rate is typically higher than the Medicaid rate.

If Your Loved One has been Abused in a Nursing Home or Assisted Living Facility

We sincerely hope you will never need us, however, if your loved one has experienced abuse or neglect in a nursing home or assisted living facility, our attorneys can help.  We have significant experience with nursing home abuse and neglect.  Please contact us at (602) 461-8640 to discuss your family’s situation.

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