Who pays ????

1 - Private

Most homes require full financial disclosure from residents who will be paying privately. Since many nursing home residents who enter as private pay residents eventually use up their funds and go on Medicaid, the homes want to know how long the resident will be able to pay privately and when to apply for Medicaid.

Once they are eligible for Medicaid, you have the right to have Medicaid pay for your care. When this happens, the nursing home should assist in completing the necessary forms.

Also, your spouse need not spend all his/her personal resources on your care if you are institutionalized. $80,000/2,000/month

The law guarantees residents the right to control their own financial affairs as long as they are willing and able to do so, or to assign that responsibility to a friend or family member. The nursing home may be given control over a residents finances if no one else is willing to handle them.

Private long term care insurance policies are becoming more and more available. They are advertised as a possible alternative to Medicaid or as a way to avoid exhausting resources when nursing care is needed.

The federal government is now permitting NYS to authorize Medicaid without someone exhausting his/her assets. That person first purchases a long term care insurance policy sponsored by the state. Such a policy must cover at least 3 years of long. term care, six years of home care or an equivalent combination of both. of that person.

2 - Medicaid

Medicaid, established by Congress in 1965, is a government health insurance program for people of all ages whose income is too low to provide for routine care costs, or whose health care costs are too high to be covered by their income.

This health insurance covers the cost of nursing care for as long as the care is required, if a resident is eligible.

A comprehensive application process is used to determine eligibility for the Medicaid program. This process requires that applicants provide detailed information and documentation regarding income and assets.

Currently, a Medicaid recipient in a nursing home is allowed to retain $50 of monthly income as a personal needs allowance to meet personal expenses that are not covered by Medicaid.

3 - Medicare

Medicare is a federal health insurance program for disabled people and people over age 65. Skilled nursing services must be needed on a daily basis to be eligible for Medicare.

Medicare will pay a maximum of 100 days of care in an approved nursing facility for patients in need of skilled care following a hospitalization of at least three full days. To qualify, the patient must be admitted to the nursing home within 30 days of discharge from the hospital.

Medicare will not pay for a nursing home stay if it is determined that only custodial care is required, or if skilled nursing home care and/or rehab services are needed only on a periodic basis.

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