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Do You Have to Pay for a Nursing Home?
Date Updated: July 26, 2024
Written by:
Rachel Lustbader is a writer and editor with a background in healthcare and technology. Her work has been published on websites including HealthCare.com, BiteSizeBio.com, BetterHelp.com, Caring.com, and PayingforSeniorCare.com. She studied health science and public health at Boston University.
Both of Rachel’s grandmothers had very positive experiences in senior living communities, and Rachel saw firsthand the impact that kind, committed caregivers and community managers can have on seniors’ and their family members’ lives. With her work at Caring, Rachel hopes to help other families find communities, caregivers, and at-home products that benefit elderly loved ones and make life less stressful for family caregivers
Generally, you do have to pay for a nursing home, and unfortunately, the cost of care isn’t cheap. In fact, seniors can expect to pay an average of $7,908 per month for a semi-private room, and a fully private room costs about $1,000 more. If you don’t have enough money for care, however, the government may cover the cost of a nursing home through its Medicaid program. Below, learn about your options and find out if you may qualify for financial assistance.
Nursing Home Medicaid
Eligibility requirements may differ depending on the state in which you live. General requirements include:
- You must need help with your activities of daily living, such as mobility, eating, bathing and dressing.
- You must be determined to require a nursing facility level of care. This assessment considers factors such as the level of medical assistance needed and whether the person is cognitively challenged due to disability, Alzheimer’s or other condition that affects decision making.
- In 2023, your income must be $2,742 per month or less.
- Countable assets, such as bank accounts, cash and investments, must total $2,000 or less. Your primary residence is excluded from the limit.
If you earn too much for Medicaid, you can spend down your income and assets until you reach your state’s medically needy income limit. However, be aware that Medicaid has a five-year look-back period to ensure you didn’t sell assets for less than fair market value or give them away to family members and friends.
Other Options
If you don’t qualify for Medicaid, you may have to pay for a nursing home using personal resources, such as savings, pensions, retirement income or money earned through property sales. Long-term care insurance pays for nursing homes, as well. If you have life insurance, you can sell or surrender the policy and use the accrued cash value to cover the cost of care.
For veterans, VA benefits will pay for care in a nursing home, assisted living facility, adult day health center or private home. This is similar to Medicaid in that it covers 24/7 nursing, comfort care, physical therapy and help with ADLs. The VA prioritizes veterans who are permanently disabled and those who need nursing care due to a service-connected disability.