How on earth do elderly adults with pensions above the Medicaid limit afford nursing homes?

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Assets are spent down on the cost of care, until she qualifies asset wise. That includes all assets such as houses, stocks, retirement accounts. Then you turn the monthly income over and pay as much as possible from her income. After that the nursing facility (ideally) helps you apply for Medicaid and submits the cost difference from her monthly income and the remainder of the bill, for payment to the state/Medicaid. The state would not take credit card debt into consideration. Nursing home costs come first. She would also get a small stipend that the government allows her to keep each month. Having income and assets allows more options to pay for care than the ones that Medicaid pays for (typically nursing homes only, there are some hard to get waiver programs that pay for at home support services, but lots of waitlists.)


I don’t see a good reason a 91 year old with no assets living in a nursing home should even pay debts. If her income is all social security and pension, debtors can’t even touch that income. She’s judgement proof.


I really don’t understand a 91 year old paying for life insurance. Only way I could see it if it is a significant enough policy to cover funeral, all previous debts, etc. Maybe?


Don’t ask nursing homes or assisted living facilities about Medicaid eligibility. They’ll get it wrong. Guaranteed. Even state and county level Medicaid offices miss the mark, OFTEN. See an elder law attorney. This is what we do. Edit: Anticipating pushback from people defending SNF’S, Let’s also address the elephant in the fucking room: profits. SNF’s are not incentivised to help you qualify for Medicaid. Why? Because a private paying patient or a Medicare patient brings in about 3-5x more money than a Medicaid patient each day. When I see SNF’s doing apps for people, it’s often when that person is otherwise not paying and forced discharge is not an option for the SNF. Is helping someone with their Medicaid application in that situation generous or is it entirely self interested? The hourly workers might genuinely mean well, but the corporate office does not. Walk into a SNF with cold hard cash and proof of ability to pay cash for ten years. See how long it takes for them to find a bed. Now ask them if they’ll take a Medicaid patient and see what happens. “Oh, sorry. Our Medicaid beds are full”. Bullshit. Theres no such thing. The concept of “limited Medicaid beds” is made up to turn potential Medicaid residents away. Medicaid law treats all beds the same. So who are you going to trust? A profit motivated institution that owes you absolutely no duty of loyalty or truthfulness and whose profit margins narrow with every new Medicaid patient? Or an attorney, who while also profit motivated, at least owes you a legally binding duty of loyalty and truthfulness and whose sole job it is to help you navigate the system?


Once her income drops below her housing costs, it eventually eat away at all of her assets. She will become a ward of the state and be allowed to keep a rolling max of about $2500.00. She will be allowed to keep about $40.00 a month (until she reaches a max of $2500). Everything will go to the nursing home. Here are only a few number of beds available for wards of the state so it is important that someone have enough money to buy their way in to a good nursing home that will keep them after the money runs out. My grandmother went in at 85 and lived in one as a ward of the state until her death at 104.