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Will Medicare or Medicaid pay for long-term care at nursing home?

My mother is 76 years old now and on a limited income. When she's ready for a nursing home will that be paid by Medicare or Medicaid or will we have to pay? I don't really know the difference between those two. I'm her only child and don't have a job right now so I'm obviously worried about this. Thanks.

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Submitted Fri, 02/07/2014 - 10:27

You are very smart to be considering this right now. You can start the elder estate planning so that when the time comes for the nursing home, medicare/acid will cover it.

The short answer to your question is that if your mother has more assets than are allowable under Medicare, she will have to pay for the home herself until almost all her money is gone.

But with proper planning now, you can help ensure that her assets will be available for her everyday use and, upon her death, that medicare will not be able to take her assets.

The consultation is free. You and your mother should come in and have a discussion with me so I can understand her current situation and lay out a game plan to protect her assets. Once she's ready to go into the hospital, it will already be too late.

I would love to help you with this. Give me a call or an email and we'll schedule a free consultation. I have a lot of openings all next week.


Good advice from Attorney Hemingway.  The easiest way to think about this issue is to think of Medicare, a program run by the federal government, as an insurance program, like social security.  As part of the Social Security program, Medicare is funded by a trust fund that workers pay into.  The money is available to those over 65 and to younger, disabled people, without regard to their income.  But Medicare covers short-term expenses, such as the cost of a rehabilitation stay after surgery or the cost of an at home health aid.  Because it is designed for short-term care expenses, when the individual's benefits expire, she or her family must look for other ways to pay, such as Medicaid.
Medicaid (known as MassHealth in MA) is a needs based program that is funded by federal and state taxes.  By needs based, we mean that if you have too many assets or too much income you will not qualify.  So, if your mom qualifies, based on low income etc., then Medicaid may pay for her long term care.  Depending on her income and assets, your mom may be responsible for paying for her own long-term care until such time as she qualifies for coverage.  That is why many people who have assets engage in planning to avoid using their own assets for long term care, such as by using Medicaid Planning trust, for example.  I hope that helps.

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