How To Pay For a Nursing Home With No Money: Options and Alternatives
November 30, 2023
As the population ages, the need for long-term care, including nursing home facilities, has become increasingly prevalent. One of the major concerns for seniors and their families is how to pay for nursing home care, especially if they have limited financial resources.
If you’re struggling to find skilled nursing care or are worried about the financial implications of such complex and clinical care, there are options for you and your family members. In this article, we will explore various avenues and strategies for financing nursing home care when money is tight, including alternative options that allow seniors to age in place.
Table of Contents
- How Much Does a Nursing Home Typically Cost?
- How To Reduce Nursing Home Costs
- Will Medicare Pay for a Nursing Home?
- Will Medicaid Pay for a Nursing Home?
- How To Find a Nursing Home That Takes Medicaid
- Can Social Security and Supplemental Security Income Pay for a Nursing Home?
- Can Long-Term Care Insurance Help Seniors?
- Other Ways To Pay for Nursing Home Care
- Alternatives To a Nursing Home
- Benefits of Aging in Place
- Grants for Home Modifications
How Much Does a Nursing Home Typically Cost?
Before delving into payment options, it’s crucial to understand the different types of senior living available to older adults. While the term “nursing home” is sometimes used by older adults or family members, it isn’t used anymore in the long-term care industry. Instead, there are four main types of senior living communities that each provide specialized care to suit their residents:
- Independent living, which serves residents who are active, independent, and require no onsite care giving staff. While most independent living communities do employ a full time nurse for resident consultations and questions, there are no caregivers available for residents onsite.
- Assisted living, which serves residents who need extra socialization or support with at least one activity of daily living, such as dressing, grooming, bathing, or eating. Caregivers are available around-the-clock and can provide assistance with personal care tasks.
- Memory care, which serves residents living with Alzheimer’s disease or other types of dementia.
- Skilled nursing, which provides skilled clinical care to residents around-the-clock. This is the most clinical type of senior living option. Residents live here long-term or short-term, depending on their needs.
Now that you have a brief understanding of senior living types, you can begin to research the costs associated with skilled care services. According to the U.S. Administration for Community Living:
- The average cost of a semi-private room in a long-term skilled care is around $6,844 per month
- The average cost of a private room can is $7,698 per month
- Assisted living is about $3,628 per month
These figures can be overwhelming for families, especially those with limited incomes and savings. However, knowing the types of care you or your loved one need can help you narrow down options before searching for financial support.
How To Reduce Nursing Home Costs
Reducing nursing home costs, whether assisted living or skilled care, is a top priority for many families, and there are several strategies to consider. Shared rooms, for instance, are an excellent way to save on expenses, though this option is not always available in assisted living or skilled care communities. Shared rooms typically cost less than private ones, which can significantly reduce the monthly bill. While privacy may be sacrificed, this option can make nursing home care more affordable for those on a tight budget.
Additionally, reducing the cost of amenities can lead to substantial savings. Nursing homes often offer various services and amenities, some of which may not be necessary for all residents. Families can negotiate with the facility to exclude services that are not essential for the resident’s well-b eing. This can help tailor the care plan to meet specific needs while minimizing the overall cost.
Will Medicare Pay for a Nursing Home?
Medicare, the federal health insurance program for individuals aged 65 and older, does cover certain aspects of nursing home care, but only for skilled nursing facilities. Medicare does not cover assisted living.
Medicare Part A, in particular, can help with the cost of skilled nursing care, but there are limitations. Medicare Part A may cover up to 100 days of care in a skilled nursing facility following a hospitalization, provided the following criteria are met:
- The senior must have a qualifying hospital stay of at least three consecutive days.
- The nursing home care must be for a condition related to the hospitalization.
- The senior must require skilled nursing or rehabilitation services.
If qualifications are met, Medicare will pay for skilled care. At 100% for the first 20 days. Days 21-100 are covered at 80%, but only as long as the resident is showing progress with meeting their care plan goals.
Further, it’s essential to note that Medicare Part A does not cover long-term care or custodial services. Medicare payment is just for rehab services that are short-term. Once Medicare benefits are exhausted, other means of payment become necessary.
To explore more details about Medicare coverage, visit the CMS website.
Will Medicaid Pay for a Nursing Home?
Medicaid, a state and federally-funded program, is the primary means for lower-income individuals to pay for long-term care, including care in a skilled nursing facility. As for assisted living, Medicaid can be used to offset those costs as long as the senior living community accepts Medicaid as payment. It’s important to ask during the research phase if Medicaid will be a part of your payment plan.
For skilled nursing care, Medicaid can significantly decrease costs for those who qualify. It’s important to note that Medicaid beds often have a waiting list. Begin searching for Medicaid skilled nursing communities soon if that is a part of your financial plan.
Medicaid nursing home coverage typically includes:
- Room and board.
- Nursing and medical care.
- Personal care services.
- Medical supplies and equipment.
The specific amount Medicaid pays for nursing home care and the duration of coverage can vary. In many cases, Medicaid can cover the entire cost of care, leaving the resident responsible for only a small monthly personal needs allowance. The length of coverage may extend as long as the individual continues to meet the eligibility requirements.
It’s important to remember that Medicaid has strict income and asset limitations, and individuals must “spend down” their assets to qualify. Each state has different thresholds and rules for Medicaid eligibility, so it’s advisable to consult with a Medicaid specialist or an elder law attorney to navigate the application process.
If you are already a resident of a skilled nursing facility, the Social Worker can help you understand your Medicaid options for payments moving forward.
How To Find a Nursing Home That Takes Medicaid
Finding a nursing home, both assisted living and skilled care, that accepts Medicaid can be challenging, as not all facilities participate in the program.
Here are some steps to help you locate a nursing home that takes Medicaid:
- Consult your state’s Medicaid office: They can provide a list of nursing homes in your area that accept Medicaid.
- Use online directories: Websites like gov and Nursing Home Compare by Medicare can help you find Medicaid-certified facilities.
- Seek recommendations: Ask friends, family, or healthcare professionals for referrals to nursing homes with a good reputation for Medicaid services.
- If you’re already living in a senior living community, the experts on staff there can point you in the right direction to finding other communities that accept your preferred form of payment in the future.
Once you’ve identified potential options, visit the facilities in person to assess the quality of care and accommodations before making a decision.
Can Social Security and Supplemental Security Income Pay for a Nursing Home?
Social Security benefits and Supplemental Security Income (SSI) can help seniors with limited income cover some nursing home costs. Social Security payments are based on an individual’s or couple’s work history, while SSI is designed for those with little or no income and minimal assets.
Social Security benefits can be used to contribute to nursing home expenses, but the amount may not fully cover the cost of care. SSI, on the other hand, provides additional financial assistance to those in need. As of 2021, the federal SSI payment is $794 per month for individuals and $1,191 per month for couples.
These payments can be applied toward nursing home expenses, but they are generally insufficient to cover the full cost. Seniors receiving Social Security or SSI may need to explore additional options to bridge the financial gap, such as Medicaid or long-term care insurance.
Can Long-Term Care Insurance Help Seniors?
Long-term care insurance is designed to cover the costs of nursing home care and other long-term care services. While having long-term care insurance can significantly ease the financial burden, it’s essential to purchase a policy before health issues arise, as pre-existing conditions may disqualify individuals from coverage or make premiums prohibitively expensive.
Be sure you understand your policy, if you have one, so that you can make financial decisions appropriately. You can call your insurance company with specific questions so that you understand your policy better.
Other Ways To Pay for Nursing Home Care
Apart from government programs and insurance policies, there are other avenues to explore when it comes to funding nursing home care. Veterans and their spouses may be eligible for certain benefits through the Department of Veterans Affairs. VA Aid and Attendance benefits can offset the costs of assisted living or skilled care, if you qualify. Talk to your VA representative to learn more.
Additionally, some non-profit organizations and charities offer financial assistance to seniors in need. Start at your town’s senior service department or your local senior service agency to learn more about local support.
Alternatives To a Nursing Home
Aging in place, or the ability to remain in one’s home and community safely and independently, is a popular and viable alternative to nursing home care. Many seniors prefer this option as it allows them to maintain their independence, stay close to loved ones, and retain a sense of familiarity.
Benefits of Aging in Place
Aging in place offers numerous benefits, including emotional well-being, social connections, and a sense of control over one’s life. Seniors can modify their homes to enhance safety and accessibility, making it easier to navigate daily activities. Additionally, staying at home often promotes better physical health by reducing the risk of infections commonly associated with communal living spaces.
Grants for Home Modifications
To facilitate aging in place, there are various grants and assistance programs available to help seniors modify their homes. These modifications can include installing grab bars, ramps, stairlifts, and wider doorways to accommodate mobility aids.
The U.S. Department of Agriculture offers its Single-Family Housing Repair Loans & Grants program, also known as the Section 504 Home Repair program. The program provides loans or grants to lower income homeowners so they can remove health and safety hazards within their homes. Loans can be up to $40,000 and have a low 1% interest rate, while grants can be up to $10,000.
Several nonprofit organizations and charities provide financial assistance or low-cost loans to seniors for home modifications. The following are a few nonprofit organizations that may be able to help:
- Habitat For Humanity – Perhaps the best-known housing nonprofit, Habitat has an Aging in Place program that collaborates with human services organizations to evaluate senior needs and provide repairs/modifications to help seniors stay independent.
- Rebuilding Together – A national nonprofit that makes essential repairs to help people stay in their homes. Its Safe at Home program is specifically focused on seniors.
Navigating the complexities of paying for nursing home care with limited financial resources can be overwhelming, but it’s not insurmountable.
By understanding the costs, exploring government programs like Medicaid, considering long-term care insurance, and investigating alternative options like aging in place, seniors and their families can make informed decisions about their long-term care needs.