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We love and cherish our elderly family members, but there comes a time when their around-the-clock care needs preclude them from living at home or exceed their family’s ability to provide care. Even the elderly in assisted living facilities eventually require regular skilled nursing care that’s only available in a nursing home. Nursing home care costs average more than $8,000 per month per resident. When it’s time to consider full-time care, aging individuals and their family members often ask, “How do we pay for a nursing home?” Understanding the options available helps aging individuals and their loved ones to make the best possible care plan.
Medicare is the federally funded healthcare covering most seniors in the United States for their medical needs. Medicare is available for those over the age of 65 and some younger individuals with qualifying disabilities. Medicare pays for temporary stays in nursing homes; for instance, when an elderly person suffers a recoverable medical condition such as a broken hip and needs temporary care. For Medicare to pay for a temporary stay in a nursing home, a physician must order full-time nursing care for the individual during their recovery period. Medicare completely covers the first 100 days of care in a nursing home; however, this coverage requires a $204 per day co-payment after the first 20 days. For those who add supplemental Medigap insurance, their Medigap insurance may pay the monthly copay amount. Medicare is a good option for a temporary stay but does not provide funding for a permanent stay.
When a nursing home resident on Medicare requires a longer or permanent stay in a nursing home, the resident may apply for Medicaid. Nursing homes may not evict Medicare residents while they await approval for Medicaid coverage. Medicaid is the most common way to pay for nursing home care in Arizona and elsewhere. About 62% of nursing home residents use Medicaid to pay for their residency and nursing care. Most Medicare patients are eligible for Medicaid once their Medicare benefits for nursing home care run out. For those who meet the eligibility requirements, Medicaid pays for all aspects of nursing home care in Arizona, including room and board, nursing care, doctor visits, medications, mental health counseling, and social activities. It does not cover private rooms or comfort items.
Veterans have coverage for nursing home residency and care through their VA benefits as long as the veteran is already signed up for benefits through the U.S. Department of Veterans Affairs and meets the other eligibility requirements, such as serving in active duty and was honorably discharged. The VA pays for care in VA nursing homes or provides partial payment for care in community nursing homes.
Some individuals sign up for pre-paid nursing home programs and Health Savings Accounts as part of their retirement planning and use this option to pay for nursing home care when the time is right. Others use their private health insurance coverage to pay for nursing home care. Finally, some individuals pay privately for a nursing home through their personal funds, pensions, and retirement plans or fund their long-term care by selling their home. If you or a loved one need help navigating nursing home care options, a Phoenix nursing home abuse lawyer can provide guidance and ensure your rights are protected if any issues arise.
The personal injury attorneys in Phoenix, Arizona, at Knapp & Roberts have the compassion and trial lawyer skills to tell your story to a jury. We will get to know you and your family so that we can help the jury understand what has happened to you and your family and how it has changed your lives. Obtain the compensation necessary for the injuries and losses you have suffered.
