How to Pay for Skilled Nursing Care: 5 Options You Might Not Know About

With the average skilled nursing facility costing $8,000–$12,000 per month, families often face a financial crisis. Most don’t realize:

✔ Medicare only covers short-term stays (20 days fully, days 21–100 require copays)

✔ Medicaid approval can take 6+ months

✔ VA Aid & Attendance benefits pay up to $2,500/month (but 60% of eligible veterans never apply)

Shocking Stat:
42% of seniors drain their life savings within 4 months of entering skilled nursing (Genworth Financial)

"Families who plan use legal strategies to protect assets while qualifying for Medicaid—it’s not too late."

— Elder Law Attorney Mark Reynolds

Key Rules:

Requires a 3-day inpatient hospital stay first

• Days 1–20: $0
• Days 21–100: $200/day copay
• Beyond 100 days: You pay 100%

Loophole: Some Medicare Advantage Plans offer extended skilled nursing facility (SNF) coverage.

Medicaid covers long-term skilled nursing, but you must:

• Spend down assets to $2,000 (varies by state)
• Protect your home (via homestead exemptions)
• Use "Miller Trusts" for income over limits

Pro Tip: Apply 6+ months early—backdated approvals are rare.

VA Aid & Attendance Benefit:

Pays $1,936–$2,903/month for wartime veterans

Covers widowed spouses, too

No need for service-related injuries

Case Example:

A Navy vet’s family used this to cover 65% of his dementia care costs.

If your loved one has a policy:

✔ Check elimination periods (e.g., 90-day wait)

✔ File appeals for denied claims (40% succeed)

✔ Use "shared care" riders for couples

Warning: New policies now exclude pre-existing dementia.

Legal Ways to Qualify for Medicaid Faster:

Promissory Notes (Convert cash to "loans")

Annuities (Turn lump sums into income streams)

Caregiver Agreements (Pay family members fairly)

*"We saved $300k by moving Mom’s assets into a Medicaid-compliant annuity 3 years early."*

— The Carter Family

🚩 Red Flags in Facility Billing Practices

❌ "Extra fees" for basic care (e.g., toileting assistance)

❌ Pressure to private-pay first (may delay Medicaid approval)

❌ No clear cost breakdown

Q: Can I keep my house if my spouse enters skilled nursing?

A: Yes! Medicaid can’t take your primary residence if a spouse lives there.

Q: What if we can’t afford the Medicare copay?

A: Some state Medicaid programs cover the $200/day gap.

[Find Medicaid-Certified Facilities]

Consult an Elder Law Attorney (For asset protection)

Apply for VA Benefits (Takes 4–6 months)

Need Immediate Help? Call your local Area Agency on Aging at 1-800-677-1116.