Nursing Homes and How to Pay for Care

Paying for nursing home and assisted living can be expensive and it is important to understand how rates are determined, and how best to pay for the care. There are four possible sources of payment:

• Personal assets
• Medical Assistance
• Medicare
• Long-Term Care insurance

In general, Use your personal assets to pay for your nursing home care until you are eligible for Medical Assistance. It is also important to find out what is not included in the basic daily rate and what costs extra. There are laws that specify what a nursing home can include in the daily rate. If you have questions about services that are available for additional charge, ask what those charges are.

Nursing Home Rates

The system used to determine your daily rate is called case mix classification. This system assigns a classification, based on daily care needs, to each nursing home resident in Minnesota. Each classification has a corresponding daily rate. The higher the care needs, the higher the daily rate. This assessment is done no matter how short, or how long your stay is or the form of payment (i.e. Medicare, Medicaid, or residents personal assets).

Medicare/Medicaid

These programs are not the same.

Medicare is a federal program which helps pay certain health care expenses for people over 65 (and some younger disabled people). Medicare is also a government health insurance program that pays for short-term rehabilitative care. The maximum period of coverage is 100 days, which include a period in a nursing home transitional care unit (TCA).

For more on Medicare, click here.

Medicaid (called Medical Assistance in Minnesota) helps pay medical bills for people with low income and low assets. Understanding eligibility for Medicaid can be complicated and it is best to consult with someone who is knowledgeable on the subject: the nursing home social worker, the county’s Medical Assistance office, an ombudsman, or an attorney familiar with Medicaid law. Once eligible, the Medical Assistance Program pays for your care for the remainder of your stay in the facility.

For more on Medical Assistance, click here.

For further information or questions please contact us or call 1-800-893-4055