What Nursing Home Expenses are Covered By Insurance?

Unknown to most people, nursing home expenses are far higher than most people will be able to pay. The cost of even a semi-private room in a nursing home is astronomically high, with bills coming in at more than $100,000 a year in many cases. Obviously, even if you have been saving money for your entire life and have invested wisely, paying more than $100,000 a year for your care is going to force you to run through your nest egg very quickly. 

You do not want to lose all you have worked for simply because you happened to require care in a nursing home when you got older. You should not have to lose the chance to leave a legacy or to leave money to people you love. You should not have to worry about having enough to provide you with peace of mind and the quality of life you seek.  Unfortunately, if you don’t understand the rules for covering your long-term care costs, this is exactly what can happen to you.

Parman & Easterday’s legal team can help save you from this fate. Our experienced Medicaid planning attorneys will assist you in identifying your options for covering your nursing home care costs while protecting the maximum amount of your wealth and assets.

Protecting your wealth from loss due to nursing home costs will be much easier if you begin the planning process  long before you actually require nursing home care. If you don’t already have a plan in place to get your nursing home costs paid for, contact us today so we can start working with you to protect your assets.

When Does Insurance Cover the Costs of Nursing Home Expenses?

One of the biggest mistakes people make when they plan for their retirement is to believe the costs of their nursing home care will be paid for by Medicare. Many people assume Medicare is far more generous with its benefits than it really is, especially when it comes to co-insurance costs and the types of coverage Medicare will actually provide to you.

The reality: Medicare never pays for a nursing home, except temporary rehabilitative skilled care, and it does not cover the nursing home care most people end up needing. As you get older, you are more likely to go into a nursing home because of advanced age or specific conditions that render it impossible for you to take care of your basic care tasks or “activities of daily living.”   You may need help eating, bathing, walking, going to the bathroom, and doing other basic tasks. The type of care you receive in a nursing home if you cannot take care of your own life activities is called custodial care.

Medicare will not cover nursing home costs if you need custodial care. Medicare explains the limited circumstances under which your nursing home can be paid for by your coverage. You can only qualify for Medicare if you are receiving care in a certified skilled nursing facility (SNF). It must be considered “medically necessary” for you to receive skilled care. The example that Medicare gives of skilled nursing care is changing sterile dressings.

Medigap plans, which are optional plans you can purchase to extend your Medicare coverage, also do not cover custodial care and the majority of other private insurance you may have will only pay for skilled care. Even when you qualify for skilled care coverage under these policies, the time period for which you can get coverage is very limited.

How Can You Pay for Your Nursing Home Expenses?

Since nursing home expenses aren’t covered by insurance in most cases, the only two options most people have to pay for their care is private pay (which probably isn’t a viable option because nursing home care is simply too costly) or qualifying for Medicaid. The problem is, Medicaid is means-tested. If you have too many resources, it is not an option.

This leads to a situation in which you are forced to spend down your wealth and impoverish yourself before Medicaid will finally pay for the costs of care. If you don’t want this to happen, you need to plan in advance so it doesn’t.

Getting Help from A Medicaid Planning Lawyer

A Medicaid planning lawyer can provide help with planning that allows you to avoid having to pay out of pocket for costly nursing home care. To find out more about how the Medicaid planning works, join us for a free seminar. You can also give us a call today at (405) 843-6100 or (913) 385-9400 or contact us online to get personalized advice about all aspects of the planning process for long term or nursing home care.