How can I pay for nursing home care?
Medicare generally doesn't cover long-term care in a nursing home. Even if Medicare doesn’t cover your nursing home care, you’ll still need Medicare to cover your hospital care, doctor’s services, drugs and medical supplies while you’re in a nursing home.
You can switch Medicare drug plans at any time while you’re living in a nursing home. If you aren't able to join a drug plan on your own, your authorized representative can enroll you in a plan that meets your needs. Fill out and mail us an authorization form or log into your Medicare account to give us permission to talk to a person you trust (like a spouse, family member, or caregiver).
Most people who enter nursing homes start by paying for their care out-of-pocket.
Other ways to pay for nursing home care:
Medicaid
Medicaid is a joint federal and state program that helps pay health care costs if you have limited income and (in some cases) resources and meet other requirements. Some people qualify for both Medicare and Medicaid. Most, but not all, nursing homes accept Medicaid payment. Even if you pay out-of-pocket or with long-term care insurance, you may eventually "spend down" your assets while you’re at the nursing home, so it’s good to know if the nursing home you chose will accept Medicaid.
Medicaid programs vary from state to state. Most often, eligibility is based on your income and personal resources. Many states have higher Medicaid income limits for nursing home residents. You may be eligible for Medicaid coverage in a nursing home even if you haven’t qualified for other Medicaid services in the past.
If you have both Medicare and full Medicaid coverage, and you don’t choose a Medicare Advantage Plan with drug coverage or a Medicare Drug Plan on your own, Medicare will automatically enroll you in one. If you live in a nursing home and have full Medicaid coverage, you pay nothing for your covered drugs after Medicaid has paid for your stay for at least one full calendar month.
To get more information on Medicaid eligibility in your state, contact your state Medicaid office.
Long-term care insurance
This type of insurance policy can help pay for many types of long-term care, including both skilled and non-skilled care. Long-term care insurance can vary widely. Some policies may only cover nursing home care, while others may cover a range of services, like adult day care, assisted living, medical equipment, and informal home care.
If you have long-term care insurance, check your policy, or call the insurance company to find out if the care you need is covered. If you're shopping for long-term care insurance, find out which types of long-term care services and facilities the different policies cover. Also, check to see if your coverage could be limited because of a pre-existing condition . Make sure you buy from a company that's licensed in your state.
Federal employees, members of the uniformed services, retirees, their spouses, and other qualified relatives may be able to buy long-term care insurance at discounted group rates. Get more information about long-term care insurance for federal employees.
Life insurance
Some insurance companies will let you use your life insurance policy to pay for long-term care. Contact your insurance provider for more information about your options.