Table of Content
Reviewed by an award-winning attorney at DALLI MARINO
Salvatore Marino, Esq. is a founding member of Dalli & Marino, LLP, and has been the managing partner since the firm’s inception in 1996, representing clients in New York City, Brooklyn, Bronx, Queens, Staten Island, Nassau County, Suffolk County and Westchester.
Quick Answer
The cost of nursing home care in New York is staggering and rising. For example, the annual cost of a private room averages over $186,000 statewide, while a shared room averages over $176,000. Costs can increase depending on the level of care required and the facility’s location. Many families face difficult decisions about how to cover these expenses.
At Dalli & Marino, we know how overwhelming these costs can be. To help, we’ve outlined six realistic ways to pay for nursing home care in New York.
How to Pay for Nursing Home Care
While nursing home costs are expensive, you may be able to access some resources which may lessen the out-of-pocket costs. For example, Medicare may cover short-term stays. Conversely, Medicaid may cover long-term stays. Other ways to cover nursing home costs include personal finances, private insurance, veteran’s assistance programs, and life insurance.
Personal Finances
Most residents entering a nursing home use personal finances to cover the costs. This might include using personal savings, stocks, or other assets. It is also common for adult children to help offset the cost until the parent becomes eligible for public benefit programs, such as Medicaid.
Regardless of how you pay for a loved one’s nursing home stay, you must speak with a financial institution to understand all of the terms and fees involved. It is also crucial to speak with the facility to understand what types of care and services they offer.
Private Insurance
Many Americans turn to long-term care insurance to cover nursing home fees and other costs. Long-term care insurance lowers the out-of-pocket expenses for stays in a broad range of care settings, including nursing homes. However, it may be best to buy this insurance before needing it, even if it means paying premiums for many years. Premium rates are usually lower for people who are in good health when they purchase their policy.
Medicare
One of the biggest misconceptions about Medicare is that it provides long-term nursing home coverage. Medicare only covers limited periods of inpatient care in a skilled nursing or rehabilitation facility following a hospital stay. Typically, coverage is limited to up to 100 days of skilled care, and the facility must be certified for Medicare to qualify. In addition, after the first 20 days, Medicare only covers a portion of the cost rather than the full cost.
Medicaid
Medicaid is a federal program administered jointly with state governments. It pays for long-term nursing home costs for people with low income and few assets other than the house they own. It is essential to know that Medicaid is only available to people who cannot care for themselves at home, and they must meet their state’s eligibility requirements. Financial eligibility varies based on how many people live in the home. For example, in New York, a person living by themselves must make less than $1,800 a month to qualify.
Veteran’s Assistance Programs
The Department of Veterans Affairs (VA) provides nursing home accommodations and other long-term care for many veterans. Those eligible for VA assistance include:
- Veterans with a service-connected disability rating of 70% or higher.
- Veterans with a 60% or higher service-connected disability rating and are unemployable.
- Veterans with a service-connected disability that doctors determine require nursing home care.
Veterans can learn more about eligibility through the VA’s Office of Geriatrics and Extended Care.
Life Insurance
Certain life insurance policies can be used to help cover nursing home expenses. Options include:
- Cashing in a policy for its cash value
- Borrowing against the policy
- Converting the policy to provide long-term care coverage
These strategies can be an alternative for families who want to preserve assets while accessing care funding.
Paying for Nursing Home Care: FAQs
Medicare generally does not cover long-term nursing home stays. It may pay for short-term skilled care following a hospital stay, such as rehabilitation or recovery, but only for a limited period. Long-term custodial care is usually not covered.
Most nursing homes require monthly payments in advance and often require a deposit or entrance fee. Families typically pay using a combination of sources such as Medicaid, long-term care insurance, VA benefits, life insurance, or personal savings. Nursing homes also often coordinate directly with government programs or insurance providers to bill them for covered services.
The cost depends on room type and level of care: Private rooms can cost around $180,675 per year while shared rooms can cost $171,550 per year.
If a family cannot cover nursing home costs, programs like Medicaid, VA benefits, and certain state or charitable assistance programs may help. If you are concerned about whether you will be able to afford care in the future, speak with a financial advisor or elder law attorney.
