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Paying for Short-term Care

Paying for short-term care is a concern for many families. Welcov Healthcare is here to help you navigate 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

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 (rules 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. 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 or 800-657-3739
  • South Dakota Department of Social Services: www.dss.sd.gov or 605-773-3656 or  800-452-7691
  • Wyoming Department of Health: www.health.wyo.gov or 307-777-7531 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

Insurance

Long-term care insurance may help pay for many types of nursing home care, including short-term care. Coverage under long-term care policies can vary widely. Many policies have limits on how long or how much they will pay. If you have long-term care insurance review your policy carefully to determine if the care you need is covered.

Medicare

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 Part A is hospital insurance that helps pay for care in hospitals (inpatient), skilled nursing facilities (inpatient), home health care and hospice. Medicare only covers medically necessary skilled nursing facility care for a limited benefit period of up to 100 days after a minimum 3-day qualifying hospital stay. You must be admitted into the skilled nursing facility within 30 days of this qualified hospital stay for Medicare to pay skilled nursing facility benefits. Medicare pays for 100% of the care for the first 20 days of a skilled nursing stay. For days 21-100, you will be responsible for a co-pay ($148.00/day in 2013) and Medicare will pay the difference.

Medicare supplemental insurance assists with paying for gaps in Medicare coverage such as deductibles and co-insurance. Most supplemental insurance plans will pay for skilled nursing care, but only when that care is covered by Medicare. If your nursing home stay exceeds 100 days you may be responsible for all subsequent care costs. 

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. www.medicare.gov/NHCompare/ 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.

 
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