Nursing home charges are based on a basic daily rate that
includes a package of services provided by the facility. Some
specialized services may be available, but must be purchased
separately because they are not included in the basic package.
Nursing home services may be financed in several ways, but
the four most common methods are "private pay," Medicaid,
Medicare, and private insurance.
Persons who pay for nursing home care with personal resources
are called "private pay" residents. People who pay for nursing
home care out of their own pocket can expect to spend between
$25,000 and $50,000 per year in charges. It is important to
ask if a nursing home accepts Medicaid residents before you
go through the admissions process. Even if you have enough
money to pay for nursing home care now, there is always a
chance that these resources may become depleted. If a nursing
home does not accept Medicaid payments, you may be asked to
leave if your money runs out.
Medicaid coverage of nursing home payments is available to
people whose resources fall below a certain level, and to
nursing home residents who have exhausted their personal resources
paying for nursing home care. The Medicaid program is funded
by the federal and state governments to provide services for
the aged, blind, and disabled who are unable to cover these
expenses themselves. Applicants must be citizens of the United
States and must meet the required income and resource limitations.
In order to receive Medicaid benefits, you must be "deemed"
in need of assistance, with income, savings, and assets below
a level determined by the state. The Medicaid program does
allow for some assets and income to be "protected" in order
to support a resident's spouse living in the community without
losing nursing home benefits. When you go into a nursing home,
you may transfer to your spouse, the titles to your home,
car, furnishings, and an amount of money set by the state
and still be eligible for assistance under Medicaid.
more information, click here for Your Benefit Rights and Eligibility
Information Under Medicaid
Medicare is a federally funded health insurance program for
individuals over the age of 65. Medicare will pay for a portion
of nursing home expenses for 100 days following a related
hospitalization. Medicare will pay 100% of nursing home expenses
for the first 20 days of care, but after the first 20 days
of care, the resident is responsible to make a co-payment
of 20%. In order to be eligible for Medicare nursing home
benefits, residents must require skilled nursing services,
such as physical therapy. Once skilled nursing services are
no longer needed, Medicare coverage will be ended.
more information, click here for Your Benefit Rights Under
Many insurance companies offer insurance policies that pay
for certain nursing home expenses. One form of these insurance
policies is called the "Medigap" program. "Medigap" insurance
will pay for the nursing home co-payments required by Medicare
during the 21st to 100th day of Medicare coverage. Another
form of insurance for those in nursing homes is called long-term
care insurance. These insurance policies cover a variety of
services provided by nursing homes. Each long-term care insurance
policy offers different benefits, thus they must be carefully
examined before purchased.