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According to LongTermCare.gov, once you reach age 65, there is a 70% chance that you will need some kind of long-term care for the rest of your life(1).
Unfortunately, paying for this kind of care can be difficult: According to SeniorLiving.org, the median price for a semi-private room in a nursing home will be $114,665 per year as of 2025(2).
Suppose your 80-year-old mother spent a month in the hospital and was admitted to a skilled nursing facility because she was no longer able to live independently.
However, her insurance claimed she didn’t need nursing care and the nursing home wanted to take all of her Social Security and pension checks to pay the bills.
Can the nursing home take the money even though your mother has bills to pay, debts she incurred before she became ill, and a home she wants to maintain after she leaves the nursing facility?
Here’s what you need to know.
The first thing to know is that Medicare is probably your mom’s insurance company because it covers most Americans age 65 and older.
If your mom chooses a Medicare Advantage plan, the plan will be administered by a private insurance company and must cover all Medicare coverage.
Medicare does not cover routine care (called custodial care) for people who are unable to complete basic life tasks. Medicare does cover skilled nursing services for up to 100 days, but only in limited circumstances, such as when you’ve just been discharged from the hospital.
Since your mother has just been discharged from the hospital, you may want to appeal the denial of skilled nursing services. If her doctor or carer thinks your mother needs specialist care, you should see if they will support your appeal to Medicare.
Medicare provides information on how to appeal a denial to try to get coverage.
If your appeal is unsuccessful, your mother will be considered a private pay patient. While her benefits will not be forfeited, she will be charged for nursing home care and is expected to pay the bills. Nursing homes often bill upfront, so she had to bear the cost to keep her spot.
If your mother cannot pay and she is not applying for Medicare or Medicaid, the nursing home can ask her to leave with “reasonable and appropriate notice.”
Medicaid does pay for care, but she must qualify, which means she cannot have more than $2,000 in countable property or resources.
Once she is on Medicaid, she will be required to send her Social Security check to the nursing home, minus a small personal needs allowance and other insurance premiums she may pay.
So, unfortunately, under the current rules, if your mother doesn’t successfully appeal and get Medicare to pay for her skilled nursing care, the nursing home can take almost all of her money, but she still needs to stay at home.
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The best way to avoid this happening is to prepare for the opportunity of entering a nursing home by purchasing long-term care insurance.
Long-term care insurance covers the cost of in-home assistance, a nursing home, or an assisted living facility.
Without proper planning, paying for long-term care can drain your retirement funds. In many cases, the burden of paying for care often falls on family members, which can strain their finances.
When considering long-term care insurance, GoldenCare offers different options based on your needs, including hybrid life or annuity with long-term care benefits, short-term care, extended care, home health care, assisted living and traditional long-term care insurance.
You always have the option of speaking with an elder law attorney to help you appeal a Medicare denial or to see what steps can be taken to protect your mother’s assets, but nursing home planning often needs to begin long before care is needed.
If your mother’s welfare check is enough to cover nursing home expenses, and you can temporarily pay off her other debts and mortgage, then this may be your best option if the situation is indeed temporary and she wishes to return home.
If nursing home costs are too high for her to afford, finding a home health aide is also an option.
With such strict regulations surrounding long-term care, it is critical that older Americans have a strong financial cushion in their final years of life and help manage the costs of long-term care. Starting early is key, but you can also start small.
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Invest in real estate without buying a property
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Opening a gold IRA with help from Goldco allows you to invest in gold and other precious metals while also providing the significant tax advantages of an IRA.
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LongTermCare.gov (1); SeniorLiving.org (2)
This article provides information only and should not be considered advice. It is provided without any warranty of any kind.
