The most common way to pay for long-term care in a nursing home is by qualifying the patient for Medicaid. This method, more than any other, is where professional help pays for itself many times over. The Medicaid system can be a complicated maze that often requires an extremely in-depth knowledge of the rules.

In addition, understanding how one rule can work with – or against – another rule is imperative to accomplishing a positive outcome. Unfortunately, that outcome requires not just understanding the Medicaid ICP rules, but also understanding the rules and interactions regarding:

  • Real estate
  • Veteran’s benefits
  • Social Security Disability
  • Social Security Income
  • Other Gov’t Compensation Programs
  • Taxes
  • Medicare
  • Insurance
  • Mortgages
  • Notes
  • Trusts
  • Durable Powers of Attorney
  • Wills
  • Health Care Surrogate forms
  • Titling Issues
  • Beneficiary Issues
  • Probate Issues
  • Creditor Issues
  • Liability Issues
  • And much more…

All of these areas can, and often do, come into play in a comprehensive, high end, tax efficient strategy that leaves the family in the best possible financial position – and ultimately, most situations result in a combination of the predominant payment for care coming from the SMMC Long Term Care program, with additional payment coming from four additional sources, which include the following:

Medicare

Medicare is the most common short-term method of paying for nursing home costs. However, Medicare will only pay for nursing home costs if a hospital stay preceded the nursing home stay, and if the patient was in the hospital for a minimum of three midnights. Further, the nursing home stay must commence within 30 days of discharge from the hospital and it must be directly related to the reason for hospitalization. In other words, if a patient is hospitalized for pneumonia, and enters the nursing home for rehab because of a broken leg, Medicare won’t pay.