There are many questions that arise, when choosing a nursing home for yourself or a loved one. Care, location, and amenities are all examples. Moreover, one of the biggest questions is how one will be able to pay for nursing home care. Here are some important things one should know when dealing with the cost of nursing home care.
Although Medicaid will pick up as much as 100% of a resident’s nursing-home bill if necessary, those with income must effectively split the cost with the government. Nursing-home residents rarely work, but many have income from Social Security, pensions, annuities or other sources. Almost all of an individual’s income goes to the nursing home, except a “personal needs allowance” of $30 or so a month for extras like haircuts and toiletries. All income counts, including retirement and disability income.
The procedure is a bit different if the spouse of the resident does not live in a nursing home. The spouse is called a “community spouse” meaning he or she lives in the community rather than in a nursing home. They are entitled to the “Medicaid community spouse minimum monthly maintenance needs allowance,” which is a minimum of $1,750 a month (as of July 1) from your combined income. The amount the spouse outside the nursing home may keep varies due to a variety of factors. It is possible they may keep up to $2,610 as of July 1 and this figure can be even higher with a court order or a favorable ruling from a state administrative law judge.
Once the source of payment is settled, the best advice is to make sure to not fall behind on the payments. Nursing homes may evict residents, including Medicaid residents, who fall behind on their bills. Gene Coffey, a staff attorney for the National Senior Citizens Law Center says, “They can kick you out for nonpayment.” State officials say they routinely must intervene because family members fail to turn over money due to the nursing home. Also, financial abuse in which family members steal from nursing home residents is common. In this case, the state can appoint the nursing home or another guardian to receive the resident’s income on his or her behalf.
Also, financial obligations do not end at death. Federal law requires states to recoup some or all of what Medicaid spent from the estates of those who benefited under the program after turning 55. Nearly half of states put liens on nursing-home residents’ houses before they die, if they are deemed unlikely to return home, but all offer an appeals process. However, many postpone collection from widows and dependent or disabled children or exempt them entirely. States can also recover funds held in bank accounts, but many exempt joint accounts.
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