How families actually pay for senior care

Most families discover the hard way that Medicare does not pay for long-term care. This page explains, in plain English, which program pays for which kind of care. Read it before you sign anything.

What does Medicare actually pay for?

Medicare pays for medical care, not custodial care. Medicare covers a hospital stay. Medicare covers up to 100 days in a skilled nursing facility after a qualifying hospital stay, with a copay after day 20. Medicare covers intermittent home health visits when a doctor orders them. Medicare does not pay for help with bathing, dressing, meals or supervision on an ongoing basis.

When does Medicaid start paying for long-term care?

Medicaid is the largest payer of long-term care in the United States. Medicaid pays for nursing home care and, in most states, for in-home care through a waiver program. Eligibility is based on income and assets, and the limits differ by state. Many states also look back five years at asset transfers. An elder law attorney can tell you where your family stands before you spend down savings.

Who qualifies for VA Aid and Attendance?

VA Aid and Attendance is a monthly cash benefit added to a VA pension. A wartime veteran or a surviving spouse may qualify. The applicant must need help with daily activities, and must meet income and net worth limits. The money can pay a home care agency, an assisted living community, or a family caregiver. Most families have never heard of it.

Does long-term care insurance cover this?

A long-term care policy pays a daily or monthly benefit once the insured person needs help with a set number of daily activities. Read the elimination period, which is the waiting period before payments begin. Read whether the policy pays for in-home care. Call the insurer before care starts, because most policies require notice.

What do families pay out of pocket?

Home care runs roughly $28 to $38 an hour in most of the country. Assisted living averages about $5,500 a month. Memory care usually adds $1,000 to $2,000 a month. A semi-private nursing home room averages about $8,700 a month. Costs vary widely by state and by county.

The free assessment shows which of these programs may apply to your family. Start the free care assessment or use the benefits checker.

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CareBridge Navigator is an educational tool. It does not provide medical, legal, or financial advice, and it is not a substitute for care from a licensed clinician.