Mon-Fri 9AM-6PM ET   |   800.970.1964   |   Contact Us

nursing facility under medicare

How to Afford the Best Possible Nursing Facility Under Medicare

Your Guide on How to Afford the Best Nursing Facility Under Medicare

Nursing home care is a common need of the elderly. As your body and mind age, you may need assistance at some point. You’ll want to afford the best nursing facility for yourself and your spouse.

Medicare isn’t designed to offer much of anything for long-term care in a nursing home. It does cover some skilled nursing care if you stay overnight in a hospital for two nights or more.

If you are qualified or will be qualifying for Medicare and are worried about nursing care, you can relax. We will show you the way forward and guide you on planning for the best nursing facility under Medicare.

Read on for tips on researching and planning for the appropriate care for your needs.

Estimating Costs

Senior care comes with financial needs that can be overwhelming. Planning to avoid financial strain when it’s time to pay for a nursing facility is necessary.

Calculating and budgeting for your future spending in nursing care or a retirement home is possible. Budgeting helps you narrow down the best nursing care facility to fit your needs. It can also motivate you to explore various options for paying for nursing home expenses.

Before making a budget, it is vital to know the average cost of long term-care. The national average rates for long-term health care in 2021 were as follows:

  • A semi-private room costs $7,908 monthly and $9,034 for a private room.
  • A one-bedroom unit in an assisted living facility averages $4,500 per month 
  • Home health aide services run about $30 per hour
  • $29 per hour for a homemakers service
  • An adult daycare center can cost around $1,690 per month

Enquiring about different facilities near you, to compare the prices and services they offer can also help with budgeting. A long-term care cost calculator may help with the number crunching, as the calculator estimates the cost of nursing homes in your specific area.

Funding Options

Best nursing facility under medicare

Planning will ease the transition from self-care to assisted living, and choosing a program that fits your desired wants in a long-term nursing home or home care services, can also ease the transition. Here are some options:

Long-Term Care Insurance

This insurance will cover long-term care services that health insurance may not cover. These services may include palliative and hospice care.

You may purchase nursing home coverage only or go for a comprehensive care policy covering both facility and home care.

 It is wise to buy long-term care insurance early because it gets more expensive as you age.

Life Insurance

Certain life insurance policies allow you to borrow and use money against the policy to pay for long-term care. You may also have the option to withdraw your benefits and use them to pay for long-term expenses.

Check your individual life insurance policies to determine what options may be available to you.

Self-Funding

You may consider paying for care using your own money. This option means tapping into your retirement benefits, investments, or savings. It may also include income from selling your home or stocks and bonds at appropriate times. 

Using Government Programs

You can access government healthcare benefits from federal and state programs. Some of these include:

Medicare Coverage

It’s a federal government health insurance program that partly covers medical costs for the elderly aged 65 and older. People with late-stage kidney failure are also eligible.

As mentioned previously, Medicare does not cover much in terms of long-term care. The coverage that is included is for a stay lasting two or more nights in a hospital and usually encompasses your doctor’s services, hospital care, skilled nursing care, and medical supplies during that time.

Other specific services you may receive during a hospital stay under Medicare include:

  • Meals
  • Nursing care
  • Physical and occupational therapy
  • Semi-private room
  • Medical social services
  • Medications
  • Medical supplies and equipment

However, you may not receive other benefits like;

  • Long-term care
  • Routine foot care
  • Hearing aids and fitting exams
  • Cosmetic surgery
  • Eye exams related to prescribing glasses
  • Most dental work

Medicaid

This program covers medical and long-term care for people with low income and limited assets. After paying for part of your long-term care, Medicaid may also chip in when your investments have depleted.

Contact Medicare to learn more about Medicare and Medicaid programs. You can also get assistance with enrolling and other insurance options through The Medicare Family.

Program of All-Inclusive Care for the Elderly

medical care for old patients

This Medicare program covers social services, medical services, and long-term care costs for those who need care in a nursing facility. It also has options for part or all of long-term care for people with Alzheimer’s disease.

The program allows you to stay home instead of moving to a care facility, though you will still need to pay monthly charges as required.

Visit the PACE website to check if you are qualified for this program.

State Health Insurance Assistance Program (SHIP)

This program can provide you and your family with counseling and education on Medicaid, Medicare, and Medicare supplemental insurance matters. Visit the SHIP National Technical Assistance Center website to find a counselor in your state or US Territory.

Veterans Benefits

The Department of Veterans Affairs may provide long-term or at-home care for you if you are eligible for their benefits.

If you think you are eligible for veterans’ benefits, you should contact the VA Medical Center nearest you. Consider checking early as VA nursing homes have a waiting list for their services.

Get Help With Planning for the Best Nursing Facility Under Medicare

Why should you consider Medicare when thinking of your health and nursing care coverage? The program can be an excellent option for individuals aged 65 or older. However, it has many parts and options.

The Medicare Family has helped seniors navigate these options and the application process for many years. For assistance, reach out and let us help with your Medicare planning and enrollment needs.

Sylvia Gordon, aka Medicare Mama, is an expert on all things Medicare and Social Security. She is the 2nd Generation here at The Medicare Family as well as a member of the Forbes Finance Council. Sylvia has served on the advisory boards of major insurance companies like United Healthcare, Cigna, Anthem, Globe Life, and Aetna Senior Supplemental Benefits. 

In her free time, she can be found taking care of her many animals (dogs, goats, peacocks, chickens) and reading a good book. Follow her on TikTok and YouTube.

Share this article