“Aging in place”, or receiving care at home, is the desired goal of many people when thinking about their “Golden Years”. Understandably, we want to stay in our homes, our familiar surroundings, when we get old.  As we get even older, hiring in-home care, such as nursing aides and other needed services, is more desirable to nursing home placement and care. Even healthcare agencies prefer in-home care as it can be less expensive than traditional nursing home care and finding an available bed in a nursing home can be difficult.

In-Home Care vs. Nursing Home Care

In-Home Care vs. Nursing Home Care How to Stay in Control

In Home Care: Medicaid

In-home care, as well as nursing home care, can be costly.  If the eligibility requirements are met, Medicaid (not Medicare) will pay the cost, although it can be difficult to find professionals willing to work for what Medicaid pays. But what happens if in-home care is not able to provide the care needed and nursing home placement is a necessity?  There are some very important, practical rules you need to know.

Nursing Home

Financially, nursing homes take in two types of people: private pay and Medicaid.  “Private pay residents” are those who pay the monthly fee with their own money.  “Medicaid residents” are those who have no money and Medicaid pays the fee.  Nursing homes are required to have a certain number of Medicaid beds.  The majority of beds are usually private pay.

If nursing home placement is needed, the ability to choose the facility is important.  But this ability comes only if the individual can private pay for a number of months. Once the agreed upon period of private pay has elapsed, the resident can apply for Medicaid.  If the eligibility requirements are met, Medicaid will pay the nursing home, and the nursing home cannot ask the patient to leave. Placement is secure.

However, if the patient cannot pay privately, he or she will be on Medicaid.  In that event, Medicaid controls where the person in need is placed.  It will depend on where the agency finds an open Medicaid bed. The patient will not have control over placement.

Some Practical Advice

While in-home care is desirous, the timing of finances is important.  If nursing home care is a probability, spending down assets and applying for in-home Medicaid care will eliminate the ability to control placement in a facility.   It might be best to enter a nursing home of your choice now, while you have funds for private pay, rather than wait.  Investigate the possibilities now.  Find out how many months of private pay each facility would like, and plan accordingly. We can help with that plan.  There is much to consider.