Medicaid Law Demands Expert Help

The cost of a nursing home and how to pay for it

Recent surveys have indicated that the median annual cost of a semiprivate nursing home room is more than $120,000. To make matters worse, this cost is growing with the rate of inflation. This is why most people desire to turn to Medicaid to meet these costs for a loved one who is being placed into a nursing home. If you want to protect your assets you should be aware of how laws that govern Medicaid will affect your day to day life. With this information, you will need advice from an elder law attorney who understands how Medicaid is utilized in long term care facilities.

Medicaid and its complex laws regarding long-term care

There are two types of long-term care settings. One is what the general public would call assisted living and the other is a skilled nursing home. Assisted living is classified into two bed types, one being regular assisted living and the other being memory care. The rules differ in how to qualify for public benefits at an assisted living bed versus a skilled nursing bed. Gross income is extremely important for a person being placed into an assisted living bed in lieu of a skilled nursing bed. The monthly income limit for a regular assisted living bed is $1,486.51 and for a memory care bed is $1,881.51 (as of 2026). This includes gross income from social security and fixed pensions but not interest dividends or payments out of an IRA or 401K. This income is for assisted living cases only since income is not important when applying for skilled nursing assistance. Also, in a skilled nursing bed if one married couple remains at home, some income will be protected to make sure that the community spouse will have a minimum income amount.

Medicaid also comes with limits on resources. Resources are important both for assisted living beds and for skilled nursing beds. If a person is over-resourced they are not eligible for Medicaid. Assets that are countable in determining resources include life insurance, retirement plans, IRA, annuities and other financial products. There are ways of using the Medicaid rules to help protect resources and an elder law attorney who practices in the Medicaid area will be able to advise of all of these rules which can be ever changing.

If you go into an assisted living facility you will face a different set of qualifications rules than if you went into a skilled nursing facility. In both cases you may be able to do preplanning by moving assets out of your name prior to applying for Medicaid or other government assistance programs. There is a three-year lookback for gifts in an assisted living setting versus a five-year lookback for gifts in a skilled nursing setting. Any gifts found during this time can adversely affect the application. This is why Medicaid attorneys offer not only crisis planning when a person is on the verge of being admitted to long-term care facility, but also pre-planning options to try to protect assets ahead of time.