Medicare, Medicaid, veterans benefits and Social Security benefits can help older people and their families pay for care in a nursing home if they don't have money. Some families are concerned about their ability to afford this level of care, as the costs of caring for older people continue to rise. Fortunately, there are several payment methods that can help ensure that your loved one gets the care they need. In addition, you can explore other care options for older people that may better meet their needs and are often less expensive than a nursing home.Medicaid is a joint federal and state program that helps pay for health care costs if you have limited income and (in some cases) resources and meet other requirements.
Some people are eligible for both Medicare and Medicaid. Most, but not all, nursing homes accept payment for Medicaid. Even if you pay out of pocket or with long-term care insurance, you may end up spending your assets while in the nursing home, so it's good to know if the nursing home you chose will accept Medicaid. Post-acute care (PAC) or skilled nursing facility (SNF) is usually covered by Medicare or private insurance for up to 100 days (100 percent for 20 days and then 80 percent for 80 days, depending on certain criteria).
Long-term care (meals, room and board, and basic health services) is usually paid for privately until funds are spent. A “down payment” is how a person with Medicare can qualify for Medicaid, a joint federal and state program that provides health coverage to some people with limited incomes and resources, even if their income exceeds the state Medicaid limit. Below a down payment, a state allows a person to subtract their uncovered medical expenses and shared costs (such as Medicare premiums and deductibles) from your disposable income. Each state's Medicaid program covers approximately 70 percent of nursing home care.
Long-term care insurance can also pay for care in a nursing home, but relatively few people have it. The basic rule is that all of your monthly income goes to the nursing home, and then Medicaid pays the nursing home the difference between your monthly income and the amount the nursing home allows you under the Medicaid contract. Medicaid covers nursing home care for eligible beneficiaries for as long as needed, whether for a few weeks or months or for the rest of the person's life. Some centers have all the Medicaid beds, while others may have some beds dedicated to residents who pay for their care out of pocket (private payment). If you have unpaid medical bills and go to a nursing home and receive Medicaid, the program may allow you to use some or all of your current monthly income to pay for previous bills, instead of simply paying them to the nursing home, as long as you still owe these old medical bills and meet some other requirements.
In most cases, Medicaid pays 100% of the costs of a Medicaid-certified nursing home, as long as you meet all of the eligibility requirements. There is also a specialized center program for a small number of low-performing nursing homes that receive more intensive supervision and guidance on improving quality in each state. VA pension funds can be used in any way the beneficiary chooses, but help and assistance benefits are intended to help pay for long-term care services and supports provided at home or in a community for the elderly, such as a nursing home. Qin-QiOs focus on working with nursing homes, states and regions to improve quality of life and quality of care in all settings, including nursing homes.
In addition, these nursing homes meet strict quality and safety standards and are supervised by state survey agencies. CMS delegate nursing home surveys and inspections to a designated organization in each state, usually the State Survey Agency (SSA).Centers that participate in Medicaid must provide specific nursing and related services focused on ensuring the physical and mental well-being of residents. The Department of Veterans Affairs (VA) offers a combination of VA benefits to help eligible veterans and their families afford care in a nursing home. You may be eligible for care in a Medicaid nursing home even if you weren't previously eligible for other Medicaid services.
Even if Medicare doesn't cover care you get in a nursing home, you'll need Medicare to cover hospital care, medical services, medications, and medical supplies while you're in a nursing home. When an older person applies for Medicaid nursing home coverage, representatives will analyze their medical needs, income, assets, and five-year spending history to determine if they are eligible for the program. Medicare doesn't cover extended nursing home stays, but it can be used to receive short-term skilled nursing care after an injury or illness.
