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Does the Government Pay For Nursing Home Care?
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
The government pays for nursing home care when seniors don’t have enough money to pay for it themselves. Nursing homes are paid for through the Medicaid program, which ensures that elderly, disabled and low-income people get care even if they can’t afford it. It’s important to know that, unlike Medicaid, Medicare doesn’t pay for long-term stays in nursing homes, although it does cover certain medical services you need while in care.
What Does Medicaid Pay For?
In all 50 states, Medicaid covers 100% of the cost of nursing home care, which includes room and board, health care, medical supplies and meals. Maintenance, transportation to medical appointments, laundry and cleaning services are factored into the cost as well. Medicaid also pays nursing home caregivers to provide help with a resident’s daily activities of living. These may include:
- Bathing, using the toilet and grooming
- Getting dressed
- Mobility, including transfers into and out of bed
- Feeding, chewing and swallowing
If you’re considering both assisted living and nursing home care, keep in mind that Medicaid doesn’t pay for room and board in assisted living facilities. This means you would need to cover the room and board through other means.
Medicaid Eligibility and How to Apply
- Your monthly income must be no greater than $2,742.
- You must have countable assets of $2,000 or less. Countable assets include cash, bank accounts, investments, bonds and real estate, with the exception of your primary residence. Medicaid has a 5-year look-back period to ensure you didn’t give assets away or sell them for less than market value.
- You must require a nursing facility level of care. Generally, this means you have health issues you can’t manage on your own, such as needing help with IV medications, catheters or other medical services. Your level of cognitive functioning and ability to perform activities of daily living may also be considered.
- You must reside in a Medicaid-certified nursing home.
To apply, contact your state’s Medicaid office. Be prepared to supply documents supporting your eligibility, including tax returns, bank statements, family trust documents, Social Security letters and proof of health insurance coverage. Once you’ve applied, you should receive a determination letter within 45 days (or 90 days if applying on the basis of disability).