Paying for Long-term Care
Paying for quality care for you or a loved one can be stressful and confusing. We're here to help you navigate your options and answer your questions.
Understanding your options
There are many ways to pay for nursing home care: personal resources (such as funds in a personal bank account, stocks and bonds, and other investments); State assistance (medical assistance/Medicaid); long-term care insurance; Veterans Administration; Medicare; and possibly other insurances (such as certain health insurance, workers compensation insurance or auto insurance).
Medicaid eligibility is based on your income and personal resources. You may be eligible for Medicaid coverage even if you haven’t qualified for other Medicaid services in the past. You may need to spend some of your personal resources on nursing home care before becoming eligible for Medicaid coverage. There are specific rules regarding what is included as an asset and what is excluded when determining Medicaid eligibility. You cannot legally give away your assets to family members or non-family members to avoid using your assets to pay for your nursing home care. If you give away assets within 5 years of the date you apply for Medicaid (some fules may vary by state), you may be subject to a penalty and be ineligible to receive Medicaid benefits. Note* there are federal regulations referred to as “spousal impoverishment” rules to protect spouses of nursing home residents from losing all of their income and assets to pay for nursing home care for their spouse. These rules protect the spouse at home to ensure they have enough money to pay for their living expenses.
State Medical Assistance
To get additional information on Medicaid eligibility, contact your State Medical Assistance office:
- Minnesota Department of Human Services: www.dhs.mn.gov or 651-431-2000
- South Dakota Department of Social Services: www.dss.sd.gov or 605-773-3656 or 1-866-854-5465
- Wyoming Department of Health: www.health.wyo.gov or phone 307- 777-7656 or 866-571-0944
- Montana Department of Public Health and Human Services: www.dphhhs.mt.gov or 800-551-3191
- Iowa Department of Human Services: www.dhs.state.ia.us or 515-281-5454
- Nebraska Department of Health and Human Services: dhhs.ne.gov or 402-471-9147
Long-term care insurance may help pay for many types of nursing home care. Coverage under long-term care policies can vary widely. If you have long-term care insurance review your policy to determine if the care you need is covered. We can assist you in researching your insurance coverage.
Medicare is a health insurance program for individuals age 65 or older, those under age 65 with certain disabilities, and individuals of any age with End-Stage Renal Disease. Medicare does not generally cover long-term stays in a nursing home (room and board) to help with activities of daily living like eating, bathing, dressing and assistance with using the bathroom. Medicare only covers medically necessary skilled nursing facility care for a limited benefit period after a 3-day qualifying hospital stay.
To get additional information, check out the resources below:
Centers for Medicare & Medicaid Services (CMS): a federal agency which administers Medicare, Medicaid, and the State Children's Health Insurance Program. http://www.medicare.gov/quality-care-finder/#nursing-home-compare or call 800-MEDICARE (800-633-4227)
State Health Insurance Assistance Program (SHIP): SHIPs are state programs that receive federal funding to provide health insurance counseling to individuals. SHIPS can provide answers to questions related to Medicare, insurance and health plan decisions and your rights.
- Minnesota State Health Insurance Assistance Program/Senior Linkage Line: www.mnaging.org or 800-333-2433
- Wyoming State Health Insurance Information Program: www.wyomingseniors.com or 800-856-4398
- South Dakota – Senior Health Information & Insurance Education www.shiine.net or 877-334-4834
- Nebraska Senior Health Insurance Information Program: www.doi.ne.gov/shiip or 800-234-7119
- Iowa Senior Health Insurance Information Program: www.therightcalliowa.gov or 800-351-4664
- Montana State Health Insurance Assistance Program: www.dphhs.mt.gov/sltc/services/aging/SHIP/ship.shtml or 800-551-3191