While nursing home care is the most expensive option for long-term care, there are several ways to cover the burden of cost, including Medicaid, Medicare, long-term care insurance and private pay.
Medicare
There is a common misconception about Medicare, in that most people think it covers nursing home care completely. In reality, it only covers a very small percentage of the costs of nursing home care, and only under very limited circumstances. For example, you must spend at least three days at a hospital for it to cover a nursing home stay and the admittance must be for rehabilitation.
If these conditions are met, Medicare will cover 100% of the cost for the first 20 days, and a smaller portion for the next 80 days. It does not guarantee 100 days of coverage, as it stops paying for the nursing home once the rehabilitation services are no longer needed. Rehabilitation is most commonly stopped because the patients health has gotten worse or the rehabilitation is not making an improvement.
Medicaid
Medicaid is funded by both the federal and the state government, and is awarded based on financial need. Each state handles it’s own program, meaning the requirements for eligibility can vary greatly state-by-state. Medicaid steps in when the cost of care depletes other options, including personal savings.
Long-term Care Insurance
Long-term care insurance will cover a portion, or in some cases, all of nursing home expenses. Each insurance company will have unique policies and coverage requirements, so if you are considering this option, consult with a qualified elder law attorney first.
Private Pay
Private pay is simply paying from the patient’s personal estate. Typically, this funding method is short-term, allowing the patient to apply for Medicaid once the assets are liquidated.
