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Legal Information

Paying for Nursing Home Care

Health Coverage benefits, Paying for medical care

Last updated on 08/23/2021 at 4:31 pm

Nursing home care is unbelievably expensive.  What options are available to help people cover the cost? This toolkit will give links to article with some short information to help you understand the basic concepts of private long-term care insurance, Medicare and Medicaid.

We want to help you understand the basic choices. Then you can begin to investigate what’s best for your situation.

There are three major options:

  •  Private long term care insurance.  Short version:  often expensive, with limited benefits.  Buyer beware. Private LTC insurance can be a good option, but look carefully and in depth before you buy.
  •  Medicare. Available to lots of people, but is limited to no more than 100 days in a beneficiary’s lifetime.  It’s good for the “short term,” but not for the long term.
  • Medicaid.  This is the big one.  Half to two-thirds of the nursing home beds in West Virginia are paid by Medicaid.  But there are substantial financial eligibility limits.  These may require you to “spend down” a lot of your own money before Medicaid kicks in. But if there is a spouse still “at home” then the “spend down” isn’t nearly so large.

NOTE: We aren’t going to discuss options to help pay for “short term” stays in nursing homes. For example, you may be recovering from surgery, an injury, or an illness, and won’t need more than a few months of nursing home (or rehabilitation center) care.  Many ordinary health insurance plans may help in this situation. We won’t be discussing this kind of insurance coverage. Instead, this Legal Aid guide is focused on coverage of true “long term” care.

Can I Buy Private Insurance to Cover Long-Term Care Costs?

Isn't Private Long Term Care Insurance Expensive?

Who is eligible for coverage under Medicare?

Does Medicare cover nursing home care?

So private insurance is expensive and hard to get, and Medicare won’t help very long. Is Medicaid a better option?

Will these FAQs tell me everything I need to know about Medicaid coverage for nursing home care?