Many older adults pay for some or all of their long-term care with their own money, also known as personal funds or “pocket funds.” Post-acute care (PAC) or skilled nursing facility (SNF) is usually covered by Medicare or private insurance for up to 100 days (100 percent for 20 days and then 80 percent for 80 days, depending on certain criteria). Long-term care (meals, room and board, and basic health services) is usually paid for privately until funds are spent. A “down payment” is how a person with Medicare can qualify for Medicaid, a joint federal and state program that provides health coverage to some people with limited incomes and resources, even if their income exceeds the state Medicaid limit. As part of an advance payment, a state allows a person to subtract their uncovered medical expenses and shared costs (such as Medicare premiums and deductibles) from their disposable income.
Each state's Medicaid program covers approximately 70 percent of nursing home care.
Long-term care insurance can also pay for care in a nursing home, but relatively few people have it.Medicaid is the leading payer for long-term care (LTC) in the U.S. In the US, and pays for at least 44% of institutional long-term care and 69% of home care. Unlike Figure 1, which reflects the number of people using any type of care in a nursing facility, including short-term specialized care paid for by Medicare and other post-acute care payers, Figure 2 reflects only spending on long-term institutional care and excludes short-term specialized care paid for by Medicare and other payers. The institutional care services in Figure 2 include the costs of extended stays in nursing facilities, intermediate care facilities, and retirement communities with ongoing care.
The costs attributable to each type of facility are unknown because national health expenditure data does not break down these costs separately. There are fewer residents in nursing facilities and nursing facilities than there was a decade ago, and now more people are using home care than care in nursing facilities, leading to the U.S. UU. The decline in the total number of nursing home residents over the past decade may partly reflect a preference for home care, including care in assisted and independent living facilities, rather than in nursing facilities.
This type of insurance policy can help pay for many types of long-term care, including specialized and non-specialized care. Skilled nursing care is often more expensive than other types of long-term care because it requires a higher level of training and experience. Until the need for care in a nursing home arises, many people don't stop to consider who pays for this type of care. If you have long-term care insurance, check your policy or call the insurance company to find out if the care you need is covered. If you're looking for long-term care insurance, find out what types of long-term care services and facilities are covered by different policies.
Care must be needed for the same condition that required treatment during the 3 days of hospitalization or for another condition that developed while receiving skilled nursing services to treat the original condition treated during hospitalization. In addition, many centers offer both short-term care in skilled nursing facilities and long-term care in nursing homes. If you live in a nursing home and have full Medicaid coverage, you won't pay anything for covered drugs after Medicaid has paid for your stay for at least one full calendar month. Skilled nursing is a type of care that is usually provided in a nursing home or other long-term care facility.
People can't simply decide that they need nursing care because of their aging, plan an eligible 3-day hospital stay, and receive care in a Medicare-funded nursing facility. For example, an older person must have been hospitalized for at least three days to cover skilled nursing care. In addition, Medicaid will only pay for skilled nursing care received at a Medicare-approved facility. The cost of such a policy is very high, and if a person does not yet have long-term care insurance, it is very unlikely that an insurance company will sell one to cover current care needs in a nursing home.
This includes about 1.3 million people who went to Medicaid nursing facilities and 0.1 million people who went to intermediate care facilities.
