As the population continues to age, the demand for long-term care, including nursing homes, is steadily increasing. One of the biggest concerns for seniors and their families is how to afford nursing home care, especially when financial resources are limited.
If you’re searching for skilled nursing care or concerned about the high costs associated with complex medical services, there are ways to make care more affordable. In this article, we’ll explore strategies for paying for nursing home care when money is tight, including alternatives that allow seniors to remain at home.
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 discussing payment options, it’s important to understand the different types of senior living arrangements available today. Although many people still use the term “nursing home,” the industry now distinguishes among several types of senior living communities, each offering a unique level of care:
- Independent Living: Designed for active seniors who don’t require daily caregiving. While most independent living communities have a full-time nurse for consultations, no hands-on care staff are available.
- Assisted Living: Provides 24/7 caregiver support for residents needing help with activities of daily living such as bathing, dressing, and eating.
- Memory Care: Offers specialized care for individuals living with Alzheimer’s disease or other dementias.
- Skilled Nursing: Offers comprehensive clinical care 24/7, making it the most medically intensive form of senior living. Residents may stay long-term or short-term, depending on their needs.
Understanding these different types of communities can help you better anticipate costs. According to the U.S. Administration for Community Living:
- A semi-private room in a skilled nursing facility averages $6,844 per month.
- A private room averages $7,698 per month.
- Assisted living costs about $3,628 per month.
These costs can seem daunting, especially for families with limited financial means. However, identifying the right type of care can help focus your financial planning efforts.
How To Reduce Nursing Home Costs
Finding ways to lower nursing home expenses is a top priority for many families. One option is choosing a shared room, which often costs significantly less than a private room. While shared accommodations can limit privacy, they can substantially reduce monthly expenses.
Families can also save money by minimizing optional amenities. Nursing homes often provide a range of services, some of which may not be necessary for every resident. Discussing a more tailored care plan with the facility could eliminate unnecessary costs and make care more affordable.
Will Medicare Pay for a Nursing Home?
Medicare provides limited coverage for nursing home care, and only under specific circumstances. It does not cover assisted living.
Medicare Part A may pay for a short stay in a skilled nursing facility if:
- The individual has had a qualifying hospital stay of at least three consecutive days.
- The nursing home care is related to the condition treated during hospitalization.
- Skilled nursing or rehabilitation services are medically necessary.
When these criteria are met, Medicare covers:
- 100% of costs for the first 20 days.
- 80% of costs for days 21–100, as long as the patient continues to meet care plan goals.
However, Medicare does not cover long-term or custodial care. Once rehabilitation goals are no longer being met or the 100 days expire, families must find alternative payment options.
For more detailed information, see this publication on the CMS (Centers for Medicare & Medicaid Services) website.
Will Medicaid Pay for a Nursing Home?
Medicaid, a joint federal and state program, is the primary source of funding for long-term care for individuals with low income and limited assets. It can help cover the cost of skilled nursing facilities and, in some cases, assisted living.
When planning for Medicaid coverage:
- Confirm early whether a facility accepts Medicaid, as not all do.
- Be aware that Medicaid-certified beds may have waiting lists, so starting your search early is crucial.
Medicaid nursing home coverage typically covers:
- Room and board
- Nursing and medical care
- Personal care services
- Prescription medications
- Therapies
- Medical supplies and equipment
Coverage amounts and eligibility rules vary by state. Generally, individuals must meet strict income and asset requirements. Consulting a Medicaid planner or elder law attorney can help you navigate the process.
If you or your loved one are already in a skilled nursing facility, the Social Worker on staff can help you explore Medicaid options and eligibility.
How To Find a Nursing Home That Takes Medicaid
Locating a Medicaid-accepting nursing home can be challenging, but several resources can help:
- Contact your state’s Medicaid office for a list of approved facilities.
- Use online tools like the Eldercare Locator and Medicare’s Nursing Home Compare.
- Ask for referrals from friends, family, or healthcare providers.
- Consult the senior living experts where you or your loved one currently live—they often have strong networks and can offer valuable suggestions.
Once you have a shortlist, it’s important to visit each facility in person to evaluate the care environment.
Can Social Security and Supplemental Security Income Pay for a Nursing Home?
Social Security and Supplemental Security Income (SSI) benefits can help offset nursing home costs, though they typically don’t cover the full amount.
- Social Security benefits are based on your work history.
- SSI is for seniors with minimal income and assets.
In 2021, the federal SSI payment was $794 per month for individuals and $1,191 per month for couples. These funds can help with basic expenses, but most residents will need additional financial assistance through Medicaid or long-term care insurance to fully cover nursing home costs.
Can Long-Term Care Insurance Help Seniors?
Long-term care insurance is specifically designed to cover expenses like nursing home care. Having a policy can significantly ease financial burdens, but it’s important to purchase coverage before serious health issues arise. Pre-existing conditions may result in denial of coverage or significantly higher premiums.
If you have a long-term care policy, be sure to review it carefully. Don’t hesitate to call your insurance company for clarification on what services are covered and under what conditions.
Other Ways To Pay for Nursing Home Care
Beyond Medicaid, Medicare, and insurance, other options may be available:
- Veterans Benefits: Veterans and their spouses might qualify for VA Aid and Attendance benefits to help pay for assisted living or skilled nursing care. Contact your VA representative for more information.
- Charitable Organizations: Some nonprofits offer grants or low-cost loans for seniors in need. Check with your town’s senior services office or local senior service agencies for leads.
Alternatives To a Nursing Home
For many seniors, aging in place is a preferred alternative to moving into a nursing home. Aging in place enables older adults to stay in their own homes or communities while receiving the necessary support to remain safe and independent.
Benefits of Aging in Place
There are many advantages to aging in place, including:
- Improved emotional well-being by staying in familiar surroundings.
- Stronger social ties with family and community.
- Greater sense of independence and control.
Additionally, by avoiding communal living environments, seniors may reduce their exposure to infections and illnesses.
Grants for Home Modifications
Home modifications can make aging in place safer and more feasible. Common updates include:
- Installing grab bars
- Adding wheelchair ramps
- Widening doorways
- Installing stairlifts
Several programs can help cover the costs of these improvements. The U.S. Department of Agriculture’s Single-Family Housing Repair Loans & Grants program (Section 504 Home Repair) offers:
- Loans up to $40,000 with a 1% interest rate.
- Grants up to $10,000 for eligible homeowners.
Nonprofit organizations can also assist:
- Habitat for Humanity’s Aging in Place program helps seniors make safety modifications.
- Rebuilding Together’s Safe at Home program focuses on making critical repairs for seniors to stay safely at home.
Conclusion
Navigating the financial challenges of nursing home care can feel overwhelming, but it’s far from impossible.
By understanding care costs, exploring government programs, leveraging insurance options such as long-term care insurance, and considering alternatives like aging in place, seniors and their families can find ways to access the support they need while staying within budget.
