Nursing home care are usually not cheap and primarily depends on the treatment needed by your loved one. While evaluating things about nursing home care for any of your family member or loved one, the major consideration arises beforehand is about financial coverage or payout for nursing home care service.
It also depends on your country where you live and the support from the government or private entities. Like in United States, Medicare is one of the options. Medicare is important for in-hospital care, medical care, and other services. It may not cover long-term nursing care cost, but you may still be eligible. So, the best option is to find out what does a Medicare cover as part of its definition.
Similarly, United Kingdom has its own National Health System that has its own policies in covering the expenses towards healthcare by its citizens.
In India, there are various schemes by government like PMJAY, ESI and others covering general public and employees with limited income.
Let’s look at the finance options available at large:
Health insurance coverage in the form of Medicaid (US):
Medicaid is a joint venture program of United States federal and state which helps with medical expenses for people with certain limitations in resources as well as income.
Once a person qualifies for Medicaid and Medicare almost all the medical expenses get covered under it. However, all nursing homes are not linked up with the Medicaid payment system, so they might not accept it. If any payment is done from your own pocket or with long-term care insurance, then during a nursing home stay your own assets will be used up.
So, it becomes very essential to know beforehand that your nursing home care accepts Medicaid or not.
Medicaid programs are different for every state. Eligibility criteria are mainly based upon income and your own resources. Some states might have little high Medicaid limits for nursing home care residents.
It is quite possible to be eligible for Medicaid coverage in nursing home care besides being denied for Medicaid previously.
Private health insurance:
If you have opted any family health insurance package or if the patient is covered under individual health insurance paid annually. Then there is a high possibility that the nursing home care facility might be covered but it must be checked with the insurer beforehand.
Also, health insurance is usually available for those who work for the government or private organizations as well. Every person and dependent family members of the working professional may be covered under a fixed health insurance plan available as a tie-up with the organization.
As per the company norms, days might also be fixed for which nursing home care can be availed. Check the details with your company or the insurance company to be fully aware about the benefits available to you as part of your insurance plan.
Personal cost bearing all the expense:
In the case of no health insurance coverage, everything needs to be paid by the patient or family from their savings. In countries where healthcare is largely private, and you have limited sources for making the payment, you shall always research for good public healthcare facilities by government. Also check your life insurance policy. Life insurance is different from health insurance. Many a times, there is a lump-sum payment is done in cases when a critical health condition is diagnosed which may be more than enough to cover your medical treatment expenses.