Nursing home costs before Medicaid kicks in


Q. My father is 91 and entered a skilled nursing facility in January. I will be putting his house up for sale when renovations are complete. If the house does not sell before we run out of money to continue paying the nursing home, what happens to Dad in the facility? Is there a “bridge” to help cover the cost for his care until the home sells?
— Trying to help

A. You do have a bit of a bridge to help, but make sure you pay close attention to the rules.

It’s Medicare.

Because your dad has been admitted to a skilled nursing facility, Medicare Part A will cover up to 100 days of skilled nursing care, said Geraldine Callahan of Callahan Financial Services in East Hanover.

“Beginning on day 21 of the nursing home stay, there is a co-payment of $167.50 per day in 2018,” she said. “This co-payment will be covered by Medicare supplement insurance up to 100 days assuming he has one.”

Once he runs out of his Medicare skilled nursing benefits, your dad can apply for Medicaid.

To qualify, he must meet the eligibility requirements for Medicaid’s asset and income test and he must pass the pre-admission screening.

“For pre-admission screening, a state nurse must test to see if your dad needs help with at least three of his activities of daily living such as bathing, eating, transferring, maintaining continence, feeding and dressing,” she said.

Callahan said if the current facility has a Medicaid bed available, they may allow your dad to continue receiving care provided he is Medicaid-pending.

“The Medicaid application can be submitted while the senior is in the skilled nursing facility,” she said. “Seniors who have applied for Medicaid and are awaiting a decision are considered to be `pending Medicaid.'”

As soon as the home is sold, Medicaid will consider any monies received to be an asset.

If the money puts him over the asset limit of $2,000, your dad will go off of Medicaid and have to privately pay and spend down the proceeds on his long-term care until he meets the eligibility and can reapply for Medicaid, Callahan said.

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