How Can I Pay for Nursing Home Care? Is Long-Term Care Insurance a Good Option?

While Medicare covers hospital care, doctor services and medical supplies for seniors admitted to nursing homes, it doesn’t cover the cost of the stay. This reality can leave seniors in need of nursing home care to make tough financial choices. There are several ways for Hawaii kupuna to pay for nursing home care, including long-term care insurance. We will take a look at some of the options in this article.

How Can I Pay for Nursing Home Care?


There are a few ways to pay for nursing home care.


Income and personal resources


Most people start out paying out-of-pocket for nursing home care and this generally continues until resources are depleted.


Examples of income and personal resources used to pay for nursing home care are:

  • Pension checks

  • Social security payments

  • Life insurance policies

  • Savings accounts

  • Retirement account income

Medicaid


Seniors who have limited income and resources may be able to use Medicaid to cover the costs of their nursing home stay. In Hawaii, this coverage is called Institutional / Nursing Home Medicaid. It is an entitlement program that provides financial assistance only for nursing home facilities. Anyone who meets the eligibility requirements is qualified to receive benefits through this program. Between Medicare and Medicaid coverage, most nursing home costs are covered. While the majority of nursing homes accept Medicaid, not all do. Before choosing a nursing home, it is important to know whether they accept Medicaid because you could end up qualifying for the program as your resources are depleted over time.


In Hawaii, the Medicaid program is also called MedQuest. The agency that runs Medicaid is the Hawaii Department of Human Services. Hawaii seniors may be eligible for several different Medicaid long-term care programs. Each program comes with its own financial and medical (functional) eligibility requirements, as well as varying benefits. Marital status affects eligibility along with other factors. To learn more about qualifying and how to apply, visit Medicaidplanningassistance.org.


Long-term care insurance


Long-term care insurance is insurance that can help cover the costs of several types of long-term care. This type of insurance comes in many forms so seniors should make sure to find a policy that will best meet their needs. Ask questions about what the plan covers – and what it doesn’t. For example, some policies only cover nursing home care, while others cover nursing home care plus alternatives such as assisted living, adult day care or home care. Some other things to know about long-term care insurance:

  • Some plans may be limited to those with pre-existing conditions.

  • Some plans increase rates for those joining at age 60 or above so it may be worthwhile to sign up in your late 50s.

  • Long-term care insurance isn’t suited to seniors with low-income and low-resources who will have minimal to no retirement savings because they will very likely qualify for state aid.

  • Federal employees, retirees, members of the uniformed services, and their spouses may qualify for long-term care insurance at discounted group rates. Learn more about long-term care insurance for federal employees at opm.gov.

Note that Medicare is not associated with any long-term care policy. Medicare does not endorse nor sell long-term care insurance. We recommend speaking to an insurance agent at a reputable insurance agency that is licensed to sell insurance in Hawaii to discuss your options.


Contact a PBC Agent for Help


Our independent insurance agents are dedicated to assisting people on Medicare and those who are ready to transition from employer coverage to personal retirement coverage. We help kupuna understand their benefits options and apply for additional coverage, as needed. Because we represent all the major Medicare Advantage and supplement plans in Hawaii, we are able to offer unbiased advice; all at no cost to our clients.


At PBC, our clients are our number one priority and we look forward to getting to know you and your needs. Call us today at (808) 738-4500 to see how we may be of assistance.