Medicaid, through its state affiliates, is the largest single payer for nursing home care. While estimates vary, it is safe to say that Medicaid pays between 45% and 65% of the total nursing home costs in the United States.
Medicare, the federal government’s national health insurance program, does not usually cover long-term nursing home costs. However, some plans may fund temporary stays in a skilled nursing facility (SNF) if someone needs specialized care. Medicare classifies nursing home care as either skilled or custodial.
A nursing home doesn’t take all of your money the second you walk through the door. Nursing homes do cost a tremendous amount of money – often over $200 a day – so, eventually, a person may end up paying all of his money to the nursing home, if he lives long enough in the nursing home.
If you or a family member faces the need for nursing home care and have limited assets, you can use Social Security to help pay for some cost. According to the government’s latest National Nursing Home Survey, the average nursing home stay is 835 days or more than two years.
If you are unable to pay for care because of financial difficulties, you can apply for financial hardship assistance from the Government. If your application is successful, the Government will lower your accommodation costs.
Medicare covers up to 100 days of care in a skilled nursing facility (SNF) each benefit period. If you need more than 100 days of SNF care in a benefit period, you will need to pay out of pocket. If your care is ending because you are running out of days, the facility is not required to provide written notice.
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The basic rule is that all your monthly income goes to the nursing home, and Medicaid then pays the nursing home the difference between your monthly income, and the amount that the nursing home is allowed under its Medicaid contract. You may need your income to pay off old medical bills.
If your name is on a joint account and you enter a nursing home, the state will assume the assets in the account belong to you unless you can prove that you did not contribute to it. This means that either one of you could be ineligible for Medicaid for a period of time, depending on the amount of money in the account.
While there is no way that a nursing home can take your home away from you, you may be forced to sell your house/property, or take out a loan, in order to pay your expenses. This is only necessary in rare circumstances, however, and as soon as your assets drop below $34,000 you become eligible for financial assistance.
In answer to the question of how much money can you keep going into a nursing home and still have Medicaid pay for your care, the answer is about $2,000. Gifting your assets to someone else may not protect it and may incur penalties when applying to Medicaid.
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How to Protect Your Assets from Nursing Home Costs
There are five ways to pay for Long Term Care in a Nursing Home, ALF or Home and Community Based Care:
Sometimes, what people refer to as a ‘care home’ may in fact be a care home that only provides residential care, known as a residential care home. The main difference is that a nursing home always has a qualified nurse on-site to provide medical care.
A person who receives a full age pension and has just a small amount saved in a bank account, for example, will likely have their accommodation and care costs fully subsidised by the government – aside from a daily care fee, which is a proportion of the pension.