Getting Help with Nursing Home Expenses

Paying for long-term nursing home care can be both expensive and difficult. If it becomes necessary for your parents, you may want to help them figure out which public benefits programs can best help them. Here's what you need to know:

In general, Medicare will cover only a limited stay in a nursing home. Medicare will usually cover a maximum of 100 days during a benefit period in a skilled nursing facility under certain circumstances. The need for skilled nursing care must follow a hospitalization. The first 20 days are fully covered; days 21-100 require a substantial copayment by the resident. Medicare will also pay for home health care visits in some situations and 80 percent of the costs for related medical equipment.

Medicaid covers long-term care services in a nursing home or possibly in the community for those who are financially and medically eligible. But you will have to check with your state's Medicaid office to find out if you qualify. Each state has different rules for Medicaid. Most states will automatically cover long-term care for SSI recipients under Medicaid. Some have programs for the "medically needy"--people whose income is over Medicaid cut-off points but who have large medical expenses, such as nursing home bills.

If your parents receive nursing home care under Medicaid but do not receive SSI benefits, they must turn over most of their income to the nursing home. Special provisions exist, however, for a portion of the income to remain with the "at-home spouse" if only one of your parents is in the nursing home.

Some people deliberately reduce their assets to qualify for Medicaid and SSI, sometimes by giving their property or money to their children. But doing so will make a person ineligible for Medicaid for a period of time. Also, bear in mind that some nursing homes do not accept individuals whose bills will be paid through Medicaid.