Paying for a Nursing Home

Advances in medicine allow people to live longer, but they are not necessarily healthier. As people age, nursing home care often becomes the only reasonable choice. Nursing home care is expensive, and extended care is beyond the means of most families. Medicare nursing home benefits are limited, but Medicaid benefits are available for nursing home patients in many cases.

Medicaid income and asset restrictions are severe, but qualifying for the program is possible even when you have the means to private pay. When you are wondering how to pay for a nursing home, consult an elder law attorney about qualifying for Medicaid.

Advance Planning Can Make the Transition Smoother

The best time to plan for eventual nursing home care is when you are in good health. You could employ various strategies to prepare for the cost of nursing home care if it ever becomes necessary.

Long-term care insurance is available and worth considering. People with pre-existing conditions may find the cost prohibitive, and it is also expensive for people nearing retirement age. However, compared to the cost of a month in a skilled nursing facility, it may be worthwhile for some people.

Another strategy is to direct assets strategically. Medicaid has strict income and asset limits to qualify, but some assets are exempt. In addition, when an applicant is married and only one spouse needs nursing home care, the program allows the non-patient spouse to retain certain assets for their own support. An experienced Medicaid planning attorney can help an individual or family develop a strategy that will work for them.

Strategies When the Need for Care is Immediate

Unfortunately, some medical conditions progress rapidly, and catastrophic events can happen at any time. Sometimes, people need nursing home care immediately, and there is no time to plan for Medicaid eligibility.

Although the patient or their family will likely have to use their own assets to pay for care initially, there are ways to speed up eligibility for Medicaid. These include spending down excess assets, purchasing an annuity, establishing trusts, and strategic gifting, among other options.

An experienced elder law attorney can help a family develop a strategy to become eligible for Medicaid as quickly as possible. They may also be able to identify other sources of funding, such as veteran’s benefits.

Understanding the Look Back Period

The Medicaid look-back period is five years, meaning that reviewers will scrutinize any below-market transfers the applicant made in the 60 months prior to their application. Any below-market transactions will delay Medicaid eligibility.

The length of the delay is determined by dividing the total amount of the below-market transactions by the average monthly nursing home costs determined by the state. For example, if the reviewer determines there were $100,000 in below-market transfers over the preceding five years and the average cost of a nursing home in the area is $7,023 per month (the penalty divisor for 2024 in Virginia), Medicaid eligibility will be delayed for a little over fourteen  months although there are strategies to speed up the penalty period.

We Are Here To Help

Caring for aging loved ones or planning for your own long-term care can bring up a lot of questions. Whether you need guidance on nursing home planning, https://www.pzlaw.com/practice-areas/medicaid-planning/, or other elder law matters, we’re here to help you navigate the process with clarity and compassion. Contact us today to speak with a knowledgeable elder law attorneyto schedule a consultation—we’re ready to support you and your family every step of the way.