How to Pay for a Nursing Home?

August 31, 2016 | Cecil Harvell

Top Ten Elder Law Questions

 

  1. Will Medicare pay for my nursing home costs? No.  Medicare covers nursing home costs for only up to one hundred (100) days.  However, Medicaid will pay for nursing home costs for eligible individuals.
  2. How much does nursing home care cost? Nursing home care in North Carolina costs approximately $5,000.00 to $7,000.00 per month.
  3. Do I need long term care insurance? Possibly. Long term care policies usually provide at home care coverage in addition to coverage for individuals in a facility.  Most long term care policies are limited by term and dollar amount.  The insurance premium increases with longer terms and higher dollar amount coverage.  Many people opt to purchase limited long term care policies and have Medicaid asset structuring prepared just in case they out-live their long term care policy.
  4. What is the difference between an assisted living facility and a nursing home?  Assisted living facilities usually provide an apartment-like setting with on-staff nursing assistants and oversight.  Nursing homes are based on a strong medical care requirement, and the care is provided by nurses, nurse’s aides, therapists, and other medical professionals.
  5. Does Medicaid pay for at home care? Traditionally, Medicaid can under some limited circumstances cover at home care through the Community Alternatives Program.  However, there are certain times when there is a freeze on this program and one should check with the Department of Social Services.
  6. How do I become eligible for Medicaid?  In general, you must spend down all of your “countable” assets until you have only $2,000.00 remaining before you will receive Medicaid benefits.  However, with proper legal advice, there are many ways to avoid spending down assets and still receive Medicaid benefits.
  7. Can I give all of my assets to my children to become eligible for Medicaid?  No.  Gifting “countable” assets to anyone other than your spouse will create a period of Medicaid ineligibility.  This is referred to as a sanction period.
  8. How do I apply for Medicaid?  In Carteret County, Medicaid applications are at the Carteret County Department of Social Services in Beaufort.  A Medicaid case worker is assigned to each file, and will collect the required information from you to process your application.
  9. If I have to go into a nursing home, can I put all of my assets in my wife’s name to become eligible for Medicaid?  No.  The total value of all “countable” assets, whether in the husband’s name, the wife’s name, or held jointly are calculated to determine Medicaid eligibility.
  10. Can I be forced to sell my home to pay for my long term health care?  Yes.  In general, if you own your home, and your spouse is not still living in the home, the home becomes a “countable” asset, and would have to be sold, and the proceeds spent before Medicaid benefits are received.  However, the home and all real estate can be protected if the proper legal planning is prepared in advance.  Planning can involve the execution of an “intent to return home” document.  However, while this document will make the home a non-countable asset, it does not protect the home from estate recovery.  Additional planning would be required to avoid a lien eventually being placed on the home.

 

If there are any questions, please do not hesitate to contact us here in Morehead City, New Bern and/or Beaufort, North Carolina.

 

Cecil S. Harvell
About the Author
Cecil S. Harvell is AV Martindale-Hubbell Peer Review Rated in the areas of Trusts and Estates, General Practice, and Aged and Aging. Mr. Harvell is a native of Morehead City, North Carolina and was admitted to the Georgia State Bar in 1983 and admitted to the North Carolina State Bar in 1987. Read More
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