Dear Editor,
The average monthly cost of a nursing home in the United States is between $8,669 for a semi-private room and $9,733 for a private room. However, costs vary by location, the level of care, and the type of room and amenities.
Factors affecting cost
* Location: The cost of nursing homes varies greatly by state, with the Midwest and the South generally having the lowest median prices.
* Room type: The type of room you choose, whether it’s private or semi-private, affects the cost.
* Amenities: The luxury amenities and services you choose can impact the cost.
* Level of care: The level of care you need, such as 24-hour care, affects the cost.
As of July 2024, 63% of nursing facility residents in the United States paid for their care primarily through Medicaid. Medicaid is the main source of funding for most nursing home services in the country.
Medicaid is a joint state and federal health insurance program that helps low-income people pay for long-term care.
Most Medicaid-covered residents are also eligible for Medicare. Medicare usually covers the first part of a nursing facility stay, and Medicaid covers the rest.
Medicaid is a critical provider of home- and community-based care, which helps keep seniors at home with their families.
Medicaid eligibility, benefits, and coverage vary from state to state.
Other ways to pay for nursing home care include long-term care insurance, but relatively few people have it.
Medicaid typically pays 100% of nursing home costs if you meet eligibility requirements. However, the exact amount varies by state and facility.
Eligibility requirements
You must require long-term care
Your income and assets must fall below certain state-established levels
Factors that affect Medicaid payments
Income: Monthly income limits vary by state
Assets: Countable resources, such as bank accounts, stocks, bonds, and property, must be below certain state-established levels
Facility: The nursing home must be Medicaid-certified and have designated Medicaid beds
Additional considerations
* You may be allowed to keep a monthly allowance and a deduction for medical needs
* The amount of the allowance varies depending on your living arrangements, type of nursing facility, and state rules
* You may be able to exempt certain assets, such as your home, car, personal belongings, and savings for funeral expenses
Over 7 million seniors rely on Medicaid for nursing home care, according to Justice in Aging. Medicaid is the primary payer for more than 6 in 10 nursing home residents.
* Medicaid is a public health insurance program that provides health care and long-term care to low-income people.
* Medicaid is particularly important for older adults who need help with daily activities, such as eating, dressing, and bathing.
* Medicaid also helps millions of older adults pay their Medicare cost-sharing.
* Medicaid covers benefits that Medicare does not, such as dental, vision, hearing, and non-emergency medical transportation.
* Medicaid is jointly financed by states and the federal government, but administered by states.
With all the good Medicaid does for millions of Americans there is most likely some abuse and fraud of the system. An acquaintance of mine owned a nursing home many years ago. His nursing home falsely billed Medicaid hundreds of thousands of dollars. He was caught and put in prison for over four years. Because there are many who aren’t caught, millions of tax dollars are stolen. The Department of Government Efficiency hopefully can provide oversight that will eliminate or stop most of the fraud and abuse.
However, this is a critical service for millions of Americans that would be difficult if not impossible for most to be without.
Dr. Glenn Mollette
