For all practical purposes, the only “insurance” plan for long‑term nursing home care for many seniors is Medicaid. Medicare only pays for approximately 7 percent of skilled nursing care in the United States. Private insurance pays for even less. The result is that most people pay out of their own pockets for long-term care until they become eligible for Medicaid (also known as MassHealth). While Medicare is an entitlement program, Medicaid is a form of welfare. To be eligible, you must become “impoverished” under the program’s guidelines.
Despite the costs, there are advantages to paying privately for nursing home care. The foremost advantage is that by paying privately an individual is more likely to gain entrance to a better quality facility. The obvious disadvantage is the expense. In Massachusetts, nursing home fees can be as high as $15,000 a month. Without proper planning, nursing home residents can lose the bulk of their savings.
For most individuals, the object of long‑term care planning is to protect savings while simultaneously qualifying for nursing home Medicaid benefits. This can be done within the following rules of Medicaid eligibility.