Do You Want Uncle Sam To Pay Your Nursing Home Bills? Kingston, New York Medical Malpractice Lawyer Says “Fat Chance”.

Laws, Nursing Home Negligence

Have you ever thought, “Who will pay the nursing homes bills when my mom or dad enters a nursing home?” The likely answer is “YOU”. The federal government is broke and is not especially generous about paying nursing home bills. However, let’s explore the rules first.

Will Medicare pay the nursing home bills?

The only type of nursing home care that Medicare helps pay for is skilled nursing facility care. A skilled nursing facility is a special kind of facility that provides skilled nursing and rehabilitation services. The primary purpose of skilled nursing facilities are temporary stays for persons in need of rehabilitation, who intend to return to an independent lifestyle. Not all nursing homes are skilled nursing facilities.

Medicare does not pay for custodial care when this is the only kind of care you need. Custodial care is mainly for the purpose of helping you with daily living needs, such as walking, dressing and eating.

Medicare Part A can help pay for certain inpatient care in a Medicare certified skilled nursing facility following a hospital stay of at least three days in a row, not counting the day of discharge. Medicare Part A pays the full cost of the “covered services” of skilled nursing facility care for the first 20 days and all covered services for the next 80 days are paid by Medicare with the exception of a daily coinsurance amount. If you require more than 100 days of care in a skilled nursing facility, you are responsible for all charges beginning on the 101st day.

Will Medicaid pay the nursing home bills?

Custodial care in a nursing home may be covered by Medicaid if you meet the specific state and resource requirements for Medicaid assistance. In order to qualify for Medicaid, you must meet income and asset requirements–in other words, you must own nothing and have no income. You will not qualify for Medicaid to pay your nursing home bills unless you are flat broke!

If Medicare and Medicaid don’t pay for your nursing home, who will?

Most nursing home bills are paid for by personal funds unless you qualify for Medicaid or purchase long-term care insurance and it isn’t cheap. The average daily cost for a nursing home can be more than $3,000 and it’s more if you need special services, i.e., physical or occupational therapy.

The lesson for today: buy long-term care insurance while you can still afford it and don’t count on Uncle Sam to pay your nursing home bills.