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How does Medicaid reduce the cost of nursing home care?

| Dec 2, 2019 | Uncategorized

When you’re growing older, one thing you realize is that nursing home and assisted-living care are all fairly expensive. Someone who is 65 years old in 2019 has close to a 70% chance of needing at least some kind of long-term care, while around 20% of people will need it for five years or longer.

There is no question that nursing home care has the potential to destroy a family’s financial security. The costs can range into the thousands each month. One way to offset those costs is through proper Medicare and Medicaid planning.

Did you know that Medicare offers up to 100 days of nursing care per benefit period?

Medicare has limited benefits, but it will provide up to 100 days of home or outpatient therapy along with other nursing home needs if certain requirements are met. Convalescent nursing home care, which is what it’s called when you go into a nursing home after a major hospitalization or surgery, is usually covered by Medicare as it’s expected to last only a short time. Medicare can also provide support if you can stay at home for long-term care, with up to 35 hours a week of benefits for home health services. These include services such as occupational therapy, language pathology and physical therapy lasting up to 60 days.

Medicaid eligibility can help cover your long-term care needs

State Medicaid programs are different than Medicare, because they are required to cover nursing home care. However, you will need to meet the state’s financial requirements. If you have too much money in your possession, for example, you may have to go through a period of “spend down,” where you eliminate those assets to be able to qualify for Medicaid.

You’ll need to be cautious about how you do this, which is why many people who want to qualify for Medicaid work with an attorney to make sure they can qualify for Medicaid long before the need arises. You may be able to do this by setting up trusts and transferring assets out of your estate in advance of needing to qualify for Medicaid.

Overall, between Medicaid and Medicare, you can get the nursing home and long-term coverage you need if you’re able to qualify. Working with an attorney ahead of time gives you the opportunity to set up your estate plan to include this long-term care planning and to make sure the benefits are there for you when needed.


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