I placed both my parents in a nursing home. While it was not easy, it was the proper decision to meet their health and comfort needs. Few of us have the skill, time, energy or resources to provide round -the-clock care for a loved one with extraordinary needs.

Two-thirds of us will be patients in nursing homes. One-third will spend two or more years at a facility. It will cost about $220 per day for a double room – $80,300 per year.

Yep, it is cheaper to send your kid to Harvard. Twenty-two percent of all nursing home bills are paid by the patient. Health insurance policies do not cover nursing home costs.

If you are on Medicare, and you are admitted to a hospital for three days, then transfer to a nursing home for skilled care, your first 20 days will be covered. Days 21-100 will cost $152 each so long as you are making progress on your skilled therapy.

My parents had a Medicare Supplement insurance policy that would have paid the $152. They did not get the full 100 days because their progress reached a plateau. Medicare pays only about 4 percent of nursing home bills nationwide.

Medicaid (not to be confused with Medicare) pays 62 percent of all nursing home bills. It kicks in after you are down to your last $2,000. When you become a patient, you should verify that the nursing home will let you convert to Medicaid after you have spent down your resources.

When the state Medicaid office assesses your resources, if you have a spouse, he or she will be permitted to keep a minimum of $23,448 and a maximum half of your combined resources up to $117,240. Additionally, the “community spouse” will normally be able to keep the family home, household goods and car.

If you or your spouse enters a nursing home, you should request that the state Medicaid office perform a resource split immediately.

If a couple with $200,000 asks for a split as soon as one of them enters the nursing home, the community spouse will be allowed to keep $100,000, half of their total combined resources. If they fail to get a resource split until they have only $60,000 left, the community spouse will only keep $30,000.

Once you have converted to Medicaid, you are permitted to keep $40 of your income each month for incidentals. You will pay the rest of your monthly income to the nursing home or for health insurance. Medicaid will pay the balance of your monthly bill. The community spouse’s income stays with him or her. It is not counted in determining what the nursing home spouse owes each month.

The community spouse can face hardship if his or her income is much less than the income of the nursing home spouse. For this reason, Kentucky permits the nursing home spouse to transfer funds to guarantee the community spouse at least $1,939 per month. If the spouse demonstrates a special need such as housing costs in excess of $582 per month, the nursing home spouse may transfer more. The most income the community spouse may have if income is being transferred from the nursing home spouse is $2,931 per month.

Understanding and applying this complex information can be confusing and worrisome. It is best to plan for nursing home care before you or someone in your family needs it. ?

SOURCE CINCINATTI NEWS 03/31/2014

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