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Nursing home funding

Nursing home costs still rising

Nursing home can costs $8,000 a month or more than $100,000 a year. How in the heck can anyone afford this? On average individuals spend about 2.5 years in a nursing home, although the actual range varies wildly depending on the health of the patient. So, you ask again, How the heck can anyone afford to pay $100,000 a year for a nursing home???

Sources of Payment


Medicare applies to long-term care in limited circumstances, such as immediately following a hospital stay. Medicare covers short-term, physician-prescribed home health care for skilled nursing; physical, occupational and speech therapy; medical social services; and assistance with bathing, feeding and other personal care. Medicare does not pay for extended care.

Medicare also covers up to 100 days of nursing home care in limited instances, and it helps cover the cost of some durable medical equipment for home use. It also covers hospice care for people diagnosed with a terminal illness and a life expectancy of six months or less. Medicare Advantages do not provide the same benefits in a nursing home. Please read your benefits booklet so you know what your benefits are.

Florida Medicaid and other State Programs

Medicaid, the largest public payer for long-term care, may pay for nursing home care and other costs that Medicare does not cover.  Funding is usually limited but It may also cover some in-home care services. In order to qualify for Florida Long Term Care Medicaid, you must meet particular income and asset limits. A person's home, car, household belongings and funeral plans are not countable. If your over the asset and income limits and elder law attorney can help devise a plan that would allow you to qualify. The sooner you plan, the less the plan will hurt. 

Long-Term Care Insurance

Long-term care insurance helps seniors pay the costs of long-term care, preventing the depletion of life savings for extended care. However, coverage is expensive. Premiums increase with the age of the purchaser. According to The Wall Street Journal, a 55-year-old single adult can expect to pay $2,065 a year for $162,000 in benefits with 3-percent compound inflation protection (this increases your benefits to compensate for inflation).

If you earn ample income, premiums can be affordable, but you need to make sure you will still be able to pay the premium after you retire. And even if you can, you may not be able to justify the expense if you have the resources to pay for care out of pocket. Your financial planner can help guide you in this decision.

Not all long-term insurance policies are created equal, so be sure you know what you are buying.

  • Some policies cover only specific types of long-term care, while others will cover a variety, such as nursing home, assisted living or in-home care.
  • Know up front to what degree premiums may increase over time. Also be aware that premiums vary by the number of years covered under the policy. Lifetime coverage can be very expensive. 
  • Many long-term care policies have an elimination period — that is, a waiting time during which the covered individual must pay for his own care. The longer the elimination period, the lower the premium.
  • Know what percentage of daily care costs your policy will cover, and realize that inflation will increase the costs. Inflation protection is commonly sold as a rider for long-term care insurance.
  • Policies vary in how they define eligibility for benefits. Some plans, for instance, state that a senior qualifies when she can no longer perform certain defined activities of daily living.

Paying Out of Pocket

Depending on the life expectancy of the individual, their wealth, and complexity of their situations, sometimes the best strategy to pay privately for care in a nursing home. If you have to use crisis planning to become eligible for Florida nursing home Medicaid, there will be a cost of planning. I'm not talking about legal fees. Sometimes, paying privately is cheaper than going through the process of becoming eligible for Medicaid. A good elder law attorney will be willing to discuss the option of paying privately.

If you would like the guidance of an Clearwater elder law attorney who has dealt with these issues personally and has helped many Florida families successfully plan for Florida's nursing home Medicaid, please call today. (727) 586-4224

      (727) 586-4224

Elder Law & Special Needs Planning