Elder Law & Estate Planning Legal Resource: Guide to Connecticut Nursing Homes

Division of Assets and Medicaid Planning
How to Pay for the Nursing Home without Going Broke

One of the things that concerns people most about nursing home care is how to pay for that care.

There are basically three ways that you can pay the cost of a nursing home:

1. Long Term Care Insurance – If you are fortunate enough to have this type of coverage, it may go a long way toward paying the cost of a nursing home. Unfortunately, long term care insurance has only started to become popular in recent years and most people facing a nursing home stay do not have this coverage.

2. Pay with Your Own Funds – This is the method many people choose at first. Quite simply, it means paying for the cost of a nursing home out of your own pocket. Unfortunately, with nursing home bills averaging around $9,000.00 per month in Connecticut, few people can afford a long term stay in a nursing home.

3. Medicaid – This is a primarily federally-funded and state-administered program which pays for the cost of the nursing home if certain asset and income tests are met.

Since the first two methods, (long term care insurance and paying with your own funds) are self-explanatory; we will concentrate on Medicaid and Medicare.

What About Medicare?

There is a great deal of confusion about Medicare and Medicaid.

Medicare is the federally-funded health insurance program primarily designed for older individuals (i.e. those over age 65). There is a limited long term care component to Medicare. In general, if you have had a hospital stay of at least three days, and then you need to go into a skilled nursing facility (often for rehabilitation), then Medicare may pay for a while.

Typically, in that circumstance, Medicare will pay the full cost of the nursing home stay for the first 20 days and will continue to pay the cost of the nursing home stay for the next 80 days, but with a deductible that is $124 per day in 2007. Often times your Medicare supplement will pay the cost of that deductible. So in the best case scenario, Medicare may pay up to 100 days. In order to qualify for these 100 days of coverage, however, the nursing home resident generally must continue to “improve.”

While it is never possible to predict at the outset how long Medicare will cover the rehabilitation, it may fall far short of the 100 day standard. But even if Medicare does cover the 100 day period, what then? What happens after the 100 days of coverage has been used?

At that point, you are back to one of the other alternatives…long term care insurance, paying the bills with your own assets, or Medicaid.

This is an excerpt from our Guide to Connecticut Nursing Homes. The full Guide includes valuable information to help you select and pay for nursing home care without going broke. If you want to receive your FREE copy of the complete Guide, fill out this form or contact our office.

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