When it comes to paying for nursing home care, one of the biggest challenges is finding a way to cover the costs when you have low income or assets. Many seniors rely on state programs and alternative payment methods like Medicaid or long-term care insurance in order to afford the high costs of care.
However, these programs can often be difficult to navigate and require strict income and asset requirements. If you need assistance with applying for a state program I recommend contacting the nursing home administration, social services or a geriatric care manager.
The cost of nursing home care can be very expensive, and most people don’t have that much money in their savings to pay for it. If you or a loved one needs skilled nursing care but does not have the money to pay for it, there are a few options available.
One option is Medicaid. This is a government program that provides financial assistance for low-income individuals and families. Some states even provide medicaid waivers. If you qualify, it can help pay for nursing home care.
Unlike Medicare, which only covers a part of a qualified individual’s nursing home costs for up to 100 days, Medicaid is a joint federal and state benefit that can pay for a nursing home when money runs out. Medicaid is actually the largest payer for long-term care for seniors and, in most cases, will pay for the full cost of nursing home care, even if the applicant requires it for the rest of their life.Rochesterlawcenter.com
Note: A nursing home must be certified by the state before it can accept Medicaid payments. So, make sure that the nursing home you are considering is state certified.
Eligibility Requirements For Medicaid
One of the eligibility requirements for a Medicaid applicant is that you must have a low income and asset limits (low assets). Each state has its own income limit, but it is generally around a $2,000 monthly income limit.
If your income and personal savings are above the limit, you may still be able to qualify for Medicaid coverage if you are able to spend down your income on medical expenses.
Countable assets are a key factor when determining who is responsible for paying for nursing home care. These assets, which include income and savings, are factored into your income limit, or the amount of money that you can use to cover the cost of long-term care.
To qualify for Medicaid coverage, your countable assets must fall below a certain threshold. If you have countable assets above this limit, you may be responsible for paying for your own nursing home care. For more information about income limits and Medicaid coverage, contact your local Medicaid office.
Most (if not all) government programs such as Medicaid, Medicare, etc. have income limits when it comes to qualifying for them.
In addition to your income, your medical condition is also a key factor in being eligible for Medicaid services.
States have the option to establish a “medically needy program” for individuals with significant health needs whose income is too high to otherwise qualify for Medicaid under other eligibility groups. Medically needy individuals can still become eligible by “spending down” the amount of income that is above a state’s medically needy income standard.medicaid.gov
Another option is to use long-term care insurance. Long-term care insurance is a type of insurance that helps cover the cost of long-term care services, including nursing home care.
If you do not have Medicaid or long-term care insurance, you may still be able to get help paying for nursing home care. Many nursing homes offer sliding-scale fees based on your income and assets. Some nursing homes also accept volunteers in exchange for free or reduced-cost care.
No matter what your financial situation is, there are options available to help you pay for nursing home care. Be sure to explore all of your options and ask for help from family and friends if you need it.
Nursing home care can be expensive, but it does not have to be out of reach. With a little bit of research, you can find a way to pay for the care you or your loved one needs.
It is a sad reality that many people find themselves needing the kind of skilled care that a nursing home provides long before they ever expected. This can be due to a variety of reasons, such as illness or injury.
But what happens if you can’t afford to pay for nursing home care? Who pays the bill? In this article, we will discuss who pays for a skilled nursing facility and what your options are if you find yourself in this situation.
Nursing Home Care Costs
Nursing home care is expensive. The average cost of nursing home care in the United States is $100,375 per year. That’s more than $8,364 per month!
The cost falls on the individual and/or their family. Sometimes it’s the full cost and other times they are responsible for just part of the cost, depending if they have resources such as insurance, medicare, etc.
For families with limited income, this can become simply impossible. This would be in addition to other medical costs such as prescription drugs, equipment, physicians, etc. The bank accounts of most families cannot bear these expenses.
Options Available To Help Pay For Nursing Home Care
There are a few different options available to help pay for nursing home care. These include Medicaid and Veterans Affairs benefits, as well as private insurance or long-term care insurance.
- Medicaid is a government program that helps low-income individuals and families pay for medical expenses. The program is funded by both the federal and state governments.
- To be eligible for Medicaid, you must meet certain income and asset requirements.
- You may also be eligible for a Medicaid Waiver program. We recommend that you speak with a social worker or geriatric care manager for more information. Or you can contact your state’s Medicaid office – click here for information.
- Veterans Affairs benefits are available to veterans and their families. These benefits can help pay for nursing home care, as well as other medical expenses. To be eligible for Veterans Affairs benefits, you must meet certain service requirements.
- Private insurance is a policy that you purchase yourself . Private insurance can help pay for nursing home care, as well as other medical expenses.
- If you have no money, you may be able to qualify for Medicaid or Veterans Affairs benefits. However, if you have private insurance, you will likely have to use that policy to pay for nursing home care.
- Sell your home or obtain a reverse mortgage. These may be difficult for some but it may be the one option that works best for your situation.
- Reverse mortgage: A reverse mortgage is a loan against your home that you don’t have to repay as long as you live in your home. The money from the loan can be used to cover the cost of nursing home care.
- Cash out your life insurance policy, if you have one. This of course depends on the type of life insurance you have so speak with your insurance company agent.
- Long-term care insurance: This type of insurance can help cover the cost of nursing home care, but it’s important to know that it doesn’t always cover 100% of the costs.
- Some nursing homes have no waiting list and/or a high vacancy rate. If this is the case, you may be able to negotiate a fee with them.
- If you are receiving Supplemental Security Income (SSI), you may be eligible for nursing home care. SSI is a needs-based program, which means that your income and assets must be below a certain level in order to qualify.
- If you’re like most people, you probably think that Social Security will take care of all your nursing home expenses in retirement. Unfortunately, that’s not the case. Social Security only covers a small portion of the cost of nursing home care, and it generally doesn’t kick in until after you’ve spent down most of your other assets.
As you can see, there are a few options available to help cover the cost of nursing home care if you don’t have enough money.
Nursing Home Care Options
The majority of seniors who go into a nursing home do so because they require some level of supervision and/or medical attention 24 hours a day, 7 days a week.
So, options for this level of care are few and even fewer for those seniors who have no money to pay for it.
But, there are some to consider.
Adult Foster Care – is a private home that cares for just a few seniors (usually 6 or less) and provides their residents with assistance in activities of daily living such as dressing, bathing, eating, etc. Meals are provided, medications are managed, etc.
Medicare’s PACE Program – if you qualify for this program you would be cared for by a team of health care professionals for whatever needs you require in your own home.
Medicaid’s Home and Community Based Services – if you qualify for this medicaid program you would also receive care (as needed) and be able to stay at home, if possible or be cared for at an assisted living facility.
Home Health Care – it may be possible that home health care may be less expensive than a nursing home placement. Of course, this depends on the level of skilled care that your senior loved one needs. If it’s just personal care and household maintenance, a home health aide may be all that is needed.
Frequently Asked Questions
What happens if I run out of money while in a nursing home?
Unfortunately, I have seen many cases where the nursing home has dismissed or evicted a resident that can no longer pay to stay there. This is often traumatic for the patient and their family members.
“The requirements to kick a resident out for failure to pay vary from state to state. Generally, assisted living and nursing homes must notify you and your family at least 30 days before discharge, and also create a report summarizing your current mental and physical health status and your post-discharge plan of care.” – Seniorliving.org
Are family members liable for nursing home fees?
There is no federal law that requires family members to pay for nursing home care. However, some states have what are called “filial responsibility” laws. These laws allow nursing homes to sue family members of residents who are unable to pay their own bills. If you live in a state with a filial responsibility law, you may be responsible for paying your loved one’s nursing home bills. For more information about Filial Responsibility laws, click here.
How long can I stay in a nursing home?
The length of time that you can stay in a nursing home will largely depend on your income and financial resources. In many states, there are income limits or other restrictions that determine whether you qualify for long-term care coverage through Medicaid or other public assistance programs.
Additionally, some states have so-called “Filial Responsibility” laws that require adult children to financially support their parents if they are unable to do so themselves.
If you have the financial resources to pay for nursing home care, you may be able to stay in a nursing home indefinitely. However, if you are unable to pay for a private room, most nursing homes will require that you leave after a certain period of time.
When it comes to nursing home care, one of the most important considerations is figuring out who pays for it. This can be a particularly complicated issue, as there are many different factors that can come into play, including income limits and state laws.
To get help navigating this complex process, it is advisable to consult an elder law attorney. These professionals can help you understand your options and make sure that you are taking advantage of all the resources available to you.