Who pays for nursing home care?

There is so much confusion about who pays for nursing home care. The laws and regulations get more complex each year, and many families only have to navigate this issue once in their lifetime; so, the confusion is understandable.  There are, essentially, just four main ways to pay for nursing home care:

1. Traditional Long-Term Care Insurance – If you are fortunate enough to have this type of coverage, it may go a long way toward paying the cost of the nursing home. Unfortunately, only a small percentage of the population has long-term care insurance, so, most people facing a nursing home stay do not have this coverage.

New! Hybrid Long Term Care Insurance. This is a creative new strategy of self insuring using life insurance, annuities or a combination of both with a long term care rider.

It is  not traditional “use it or lose it” insurance. It has become very popular in recent years as the federal government has given some tax incentives regarding these policies

2. Personal Income and Assets – This is the method many people are required to use if they haven’t protected their money and have no long term care insurance.. Quite simply, it means paying for the cost of a nursing home out of your own pocket. Unfortunately, with nursing home bills averaging $260/day, few people can afford a long-term stay in a nursing home.  This is something we can often avoid with proper asset protection planning.

3. Medicare – This is the national health insurance program primarily for people 65 years of age and older. Medicare provides short-term (up to 100 days) assistance with nursing  costs if the beneficiary requires short-term rehab or skilled nursing services.

4. Medicaid – This is a federal and state funded and state administered medical benefit program which can pay for the cost of the nursing home if certain asset and income tests are met. Even if Medicare does cover the full 100-day period, then what? What happens after those 100 days?

Could Medicaid really be an option for you? There are strict rules about who can qualify for nursing home Medicaid, but it is the largest payer of nursing home care in Florida . We do Medicaid application for our middle class clients all the time. We have many asset protection strategies that we can use to prequalify for medicaid or even in a crisis situation.

If an older person is receiving skilled care or rehabilitation services in a nursing home that is being paid for by Medicare and if it is unclear if they will be able to return home, that is a good time to meet with us..  This gives the family of the individual in the nursing home time to consult with the elder law attorney and consider and implement any Medicaid planning options.  Many families wait to contact an us until after Medicare benefits have ended and they have been asked to start paying the private pay rate at the nursing home.  By consulting with us earlier in the process, stress can be avoided, better care decisions can be made, mistakes can be avoided, and more money can be saved.

At the Law Offices of Alice Reiter Feld & Associates, we’ve been minimizing risks and solving problems for South Florida families for 35 years. We practice Elder Law – and only Elder Law. And we’ve designed pretty much every type of estate plan you can imagine for our families…along with using estate planning tools such as wills and asset protection, and assistance with long-term care planning, Medicaid, and the VA.



Author: Alice Reiter Feld
Ms. Reiter Feld has been in private practice for over 30 years. During that time, she’s proven to be a determined fighter for the rights of senior citizens and family members when it comes to elder care options, and on the importance of engaging an elder law attorney to plan and execute a personalized strategy. Her primary areas of practice under the “Elder Law Umbrella” include long-term care needs planning, asset protection planning, estate planning, probate, Veteran’s Benefits, and Medicaid planning and assistance.