How to Pay For Skilled Nursing Facility Care
September 01, 2023 / Nursing Home
If your aging loved-one has reached a point where they need more specialized care to continue to be safe and comfortable, it is likely you are considering skilled nursing facility care. Skilled nursing facilities offer the highest level of care to seniors who need supervision, assistance with the activities of daily life, 24/7 care, medical care and medication management, and other specialized services to ensure their health and safety. Due to the high level of specialized care that a skilled nursing facility provides, it can be extremely costly. Many individuals want to ensure the best care possible for their loved ones but might face difficulties when determining how to pay for skilled nursing facility care. The team at Senior Care AZ, an Arizona senior placement agency, is breaking down the costs of skilled nursing facility care, what programs are available to assist you with covering the costs, and how different types of insurance might provide assistance.
Cost of Skilled Nursing Facility Care
A skilled nursing facility will provide a high level of custodial care as well as room, board, meals, and assistance with the activities of daily living. The costs of a skilled nursing facility generally cover the price of room and board within the facility, meals, and 24/7 supervision and care. Assistance with the activities of daily life will be included; this can include things such as help with bathing, dressing, or using the restroom. Medication management and other medical assistance will generally be covered, as well as transportation and housekeeping in the room. Skilled nursing facilities vary, and there are different options that a resident can choose that will affect the cost of a nursing home. A resident can choose to live in a semi private room, which will provide a senior with a bed in a room that is shared with another resident. There will generally be some sort of visual separation between the rooms, like a curtain or a screen. A resident can also choose to reside in a private room that will be just the bed of a senior, with no other resident living in the same room. A private room generally costs more than a semi private room, and the location of the facility will also affect the cost, which varies greatly from state to state. In Arizona, the average monthly cost for a semi private room in a skilled nursing facility is $6,540. The average cost for a private room in a skilled nursing facility is $8,030.
Who Pays for Skilled Nursing Facility Care?
The most common ways that seniors and their families pay for skilled nursing facilities are through government health programs such as Medicare and Medicaid, as well as other types of long-term care and health insurance, private pay options, retirement funds, and social security benefits.
Does Medicare Pay For Skilled Nursing Facility Care?
Most skilled nursing facilities offer both long-term care and short-term care options, which are structured more like rehabilitation facilities. Medicare provides coverage to individuals who are 65 and older and will generally cover short-term rehab stays in a skilled nursing facility but will not cover the costs of a long-term stay in a skilled nursing facility. Medicare will be a great option for seniors who need skilled nursing facility care to aid in their recovery from a fall or surgery, but it cannot be a long term solution for seniors who are hoping to live out their years in a skilled nursing facility.
Does Medicaid Pay For skilled nursing facility Care?
Medicaid is a state and federal program that covers medical costs for individuals with limited income or resources. Medicaid generally covers the costs of a long-term care facility if a senior qualifies based on their income and financial assets. Eligibility requirements for Medicaid to cover the costs of skilled nursing facility care vary on a state by state basis, so working within the guidelines for your state of residence will be necessary to determine benefits. Most skilled nursing facilities accept Medicaid, but some do not, so it is important to check with the facility prior to admission.
Does the VA Pay For Skilled Nursing Facility Care?
The U.S. Department of Veterans Affairs, or VA, provides senior care options to elderly veterans who require long-term medical assistance. Senior living that the VA covers is often determined by their medical needs, and if determined by a medical professional that a skilled nursing facility is needed, it will generally be covered by VA benefits. In some cases, the VA will pay for skilled nursing facilities, and in other cases, veterans can live in VA run skilled nursing facilities.
Paying For Skilled Nursing Facility Care With Private Pay Options
Families who cannot rely on Medicaid or VA benefits may resort to private pay options to cover the cost of skilled nursing facilities. Some options for privately paying for a skilled nursing facility include resorting to savings, either personal savings or out-of-pocket payments. This is the most common way seniors will pay for skilled nursing facilities. A pension, which is a sum of money paid on a monthly basis from a former employer, may also be an option to cover the costs of skilled nursing facility care. Individuals may also use retirement income from a 401K or a portfolio of stocks to cover the costs. Some seniors have a home that they can sell, which can provide a large sum of money that can contribute towards paying for skilled nursing facility care. Others may rely on assistance or gifts from family or loved ones to cover skilled nursing facility care expenses.
Paying For Nursing Home Care With Insurance Benefits
Some insurance plans may provide assistance with skilled nursing facility care expenses, depending on the type of plan and the individual’s eligibility.
Long-Term Care Insurance
If your loved one purchased a long term care insurance plan when they were younger, you may be able to rely on this plan to cover the costs of skilled nursing facility care. Long term care insurance is designed to pay for custodial and personal care, and skilled nursing facilities qualify as custodial care. Benefits do vary based on the plan and will not be guaranteed.
Life Insurance
Seniors with a life insurance plan may use it to cover the costs of skilled nursing facility care. Individuals can sell their plan to a third party at market value or surrender the plan for cash value, which allows them to access the money to cover costs.
Private Health Insurance
Some private health insurance plans may offer some coverage for the cost of medical care in a skilled nursing facility. Working with the facility to divide costs between medical care and personal care may allow you to get coverage for costs that are classified as medical, reducing the amount you must cover through private funds.