The cost of a nursing home stay can overwhelm seniors and their family members very quickly. According to the 2020 Genworth Toll of Care Survey, the median cost of a semi-individual room in a nursing home is $7,756 per calendar month. Fortunately, Medicare, Medicaid or both programs may exist used to cover nursing habitation expenses, depending on the circumstances. Read on to larn how to pay for nursing dwelling house care.

Medicare and Medicaid Nuts

Both Medicare and Medicaid are overseen past the Centers for Medicare & Medicaid Services (CMS). These programs are frequently confused, but they are very different. The most important differences are the ways in which they are funded/administered and the purpose each serves.

Medicare is a federal health insurance program for seniors, certain younger individuals with disabilities and people with end-stage renal disease. Similar private health insurance plans, Medicare does not comprehend long-term care of whatsoever kind. This includes in-home intendance, assisted living, memory care and nursing home care. Nonetheless, there are exceptions for the curt-term provision of similar services. For case, Medicare will cover stays in skilled nursing facilities (also referred to as SNFs, nursing homes, convalescence homes, or senior rehab facilities) for brusk-term rehabilitation following a qualifying hospital stay.

Read: Senior Rehab: Medicare Coverage of Skilled Nursing Facility Stays

Medicaid is a jointly funded federal and state medical assist program that provides health coverage for depression-income Americans with few assets. Unlike Medicare, Medicaid programs for the elderly and disabled do cover diverse long-term care services. Essentially, the Medicaid long-term care programme ensures that people who cannot beget the loftier level of care they need are still able to receive information technology. Seniors who encounter their country'due south financial eligibility requirements and have a documented medical demand for nursing home level care should qualify for Medicaid coverage of their nursing habitation costs.

For more detailed information on how these programs differ, read What Is the Difference Between Medicare and Medicaid?

Medicaid Pays for Nursing Home Care

Medicaid pays for 100 percent of a qualifying individual's nursing home costs in a Medicaid-certified facility, only it's of import to understand that it is a needs-based program. This means that an applicant's income and assets cannot exceed strict limits prepare by their state's Medicaid program. Certain assets, such as ane's main residence, are exempt from these limits. Applicants must as well meet state-specific level of intendance requirements to qualify.

While nursing home intendance is covered by every state'southward Medicaid program for all eligible applicants who need it, some states take expanded their coverage to include other types of long-term care, such as home and community based services (HCBS) and assisted living. This enables seniors with significant care needs to delay or avert placement in nursing homes and receive services in less restrictive and more abode-like environments.

Read: Qualifying for Medicaid Long-Term Intendance

Dual Eligibility for Medicare and Medicaid

Finally, proceed in mind that it is possible to qualify for and be covered by both Medicare and Medicaid simultaneously. Such individuals are known as "dually eligible beneficiaries." With dual eligibility, Medicare pays for covered medical services first and Medicaid is considered the "payer of last resort." For example, Medicare covers qualifying health intendance costs for md's appointments, durable medical equipment and hospitalizations while Medicaid covers qualifying remaining expenses, such as Medicare premiums and cost-sharing requirements and long-term care services.

Keep in mind that coverage and benefits available for dually eligible beneficiaries vary by state. To learn more than, read Dual-Eligible Beneficiaries: Some Seniors Qualify for Both Medicare and Medicaid.