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How Much Does Nursing Home Care Cost?

A senior couple sitting at a table with various bottles of prescriptions arrayed on top of it, while they review a stack of paper medical bills.Whether you are planning ahead for retirement or looking for care for an aging parent, the cost associated with nursing home care is certainly something that will cross your mind. It’s important to take a moment to break down nursing home costs, with an aim to help you understand projected expenses for proper preparation.

Average Nursing Home Costs

Nursing homes may provide both private and semi-private rooms. The average nursing home cost for a private room, according to Genworth’s 2020 cost of care study, is $105,852 annually and $8,821 monthly. If you’re looking to pay for a semi-private room, it will cost you an average of $93,072 annually and $7,756 monthly.

It is important to note that the average nursing home cost differs from state to state. States like Oklahoma may be less expensive, with an average of $56,663 annually for a semi-private room and $66,510 for a private room.

On the other hand, states like Alaska may be more spendy, with an average cost of $351,495 annually for a semi-private room and $330,873 for a private room. This price variation is dependent on the general population of the state, senior population, cost of living, and availability of nursing home facilities.

Nursing home costs are related to their extensive and specialized care, with 24/7 medical care along with services that include other health care professionals like physiotherapists and occupational therapists.

They also provide housekeeping and socialization for seniors. According to the National Care Planning Council, the average nursing home stay is 835 days.

Here is a list of features and services that nursing home fees may cover:

  • Room and board;
  • Personal care (bathing, dressing, toilet assistance);
  • Medications and monitoring;
  • 24-hour skilled nursing care;
  • Rehabilitation;
  • Social activities.

Nursing homes are not the only options available for senior care. There are alternatives to explore especially if your loved one is more independent and doesn’t need specialized care. These options can also be cheaper compared to nursing home costs, depending on resident needs and features. Let’s take a look at some of these options and how they differ from nursing home care.

Assisted Living Facilities

Nursing homes and assisted living facilities are two different care options, though people often mistake the two as one and the same. Assisted living facilities generally take more independent people who need some extra assistance and monitoring. Nursing homes may be more for more seriously ill people that need specialized care or constant medical attention.

Assisted living facilities provide personal care, and some minor assistance with activities of daily living. They’re great for seniors who are looking to socialize and build a community with other senior citizens while maintaining their personal privacy. They cost an average of $4,300 monthly and $51,600 annually, according to the Genworth survey linked previously.

Accessory Dwelling Units

Accessory dwelling units are also known as mother-in-law suites. They function as a modified apartment where seniors can keep their privacy and independence while having loved ones around. This serves as a win-win for people who need some extra care but still want to be surrounded by their family members and loved ones.

An accessory dwelling unit will have a kitchen, bathroom, and a sleeping and living space, much like a regular apartment. Although remodeling can be a bit expensive, it may still be less of an expense compared to nursing home costs. You can also receive home nursing assistance with an accessory dwelling unit. However, this might not be a great option for people with Alzheimer’s disease or dementia, as it can be disruptive.

Other options to consider include:

  • Adult day care – $1,603 (monthly)
  • Homemaker services – $4,481 (monthly)
  • Home Health Aide – $4,576 (monthly)

Does Medicare Pay for Nursing Homes?

Yes, Medicare pays for nursing home care, but with some limitations. Medicare is a federal health insurance program that provides health care benefits to Americans that are 65 years and above, providing insurance for medical services regardless of income. The program aims to assist senior citizens in the United States with health care costs.

Regarding payment for nursing homes, Medicare only pays for a short-term plan of up to 100 days. If you need to keep your loved one in a nursing home for a longer period of time, you’ll be responsible for those expenses. The program will only cover the cost if a person is referred to the nursing facility by a physician after hospital discharge.

Medicare will not cover custodial care alone, and only pays for skilled nursing care in a facility that has a Medicare license. A person can also use Medicare insurance benefits to pay for home health services of up to 35 hours per week.

The Importance of Watching for Healthcare Fraud

It is important for individuals to be aware of their rights before enrolling in a nursing home. This is because seniors are often the target of medical abuse and health care fraud. Drug fraud, medical fraud, and health insurance fraud are categorized under healthcare fraud.

It involves dishonest medical professionals taking advantage of people because of their positions. People covered by insurance benefits like Medicare and Medicaid are targets. Common fraudulent healthcare schemes include: padding a bill, performing treatments that are not necessary, fake diagnoses, billing for non-existent services, and billing different steps in a procedure separately.

A great way to arm yourself against healthcare fraud is to be informed about your medical condition and nursing care practices in general. Make sure you ask questions about your treatment, verify answers, and report any suspicious activity while on medical supervision.

If you suspect any form of abuse or fraudulent activity around your loved one’s care, you may consider taking legal action. Ensure that your loved one is open to you about their care and make them comfortable enough to speak out against any form of abuse.

Who Pays for Nursing Home Care?

There are various payment options and financial assistance available to cover nursing home care costs.

Here are some of the options available:

Medicare – Medicare is a government insurance benefit for senior citizens that are 65 years and above. It covers short-term nursing home care costs based on physician referral alone.

Medicaid – Medicaid is one of the largest single payers for nursing home care costs. However, you’ll need to meet some eligibility criteria with low income and assets.

Veteran assistance – You can qualify for veteran assistance if you’re a veteran or a surviving spouse.

Other options available are reverse mortgages and a long-term care insurance plan. You can also create a health savings account to plan your finances and save ahead for nursing home care. These accounts are tax-free when used for qualified medical services. It is never too late to start saving up for a brighter future.

Nursing home care doesn’t have to be permanent. If your loved one’s health improves or there is a need for a change, it is important to make a few logistical and financial considerations.