Most residents who enter a skilled nursing facility pay for their care with their own funds at least initially. This could mean investing in your loved one's personal savings, stocks, or other assets. However, it's not uncommon for adult children and other family members to pool funds to help cover the costs of nursing home care until their older dependent is eligible for a public benefit program such as Medicaid. Long-term care insurance is designed to reduce out-of-pocket costs for stays in a wide range of care settings, including nursing homes and assisted living facilities.
This ranges from basic health services, meals and activities to intensive health services for those who would otherwise have to be in a skilled nursing facility. In other words, Medicaid, unlike Medicare, will cover nursing home residency solely to help with the non-medical activities of daily living, called “custodial care.” First, since financial resources are private, there is greater flexibility in terms of purchasing non-institutional services, such as home care. The Balanced Budget Act of 1997 mandates the implementation of a prospective payment system (PPS) for travel expenses for skilled nursing facilities (SNF) that covers all costs (routine, ancillary, and capital) related to services provided to beneficiaries under Part A of the Medicare program. Nursing home prices can make it tempting to look for less expensive and supportive residential care options, such as assisted living.
The income limits for eligibility for Medicaid nursing home coverage are different for a single, divorced, or widowed person than for a married couple. The novel coronavirus (COVID-19) pandemic has drawn more attention to quality of care and infection control standards in nursing facilities across the country. No special paperwork is needed to apply for coverage for a Medicare nursing home; the nursing home takes care of the entire administration. And the VA pays a small portion of the cost of residency in State Veterans Homes for some veterans who are not eligible for direct care in VA nursing homes.
Multivariate techniques were used to examine the predictive power of the source of payment along with other characteristics of the facility (such as size, ownership, level of certification), services available and provided, and patient characteristics (such as ADL and diagnosis). Many Americans use long-term care insurance to cover nursing home fees and other personal care expenses in old age. If your family member purchased a long-term care insurance plan, there is a good chance that he or she will be able to receive funds to cover the costs of nursing home care. If your loved one has a life insurance policy, collecting it can help pay for the costs of a nursing home, and certain types of life insurance will allow the policyholder to use it as long-term care insurance.