Choosing a skilled nursing facility is a big decision no matter if your stay is going to be a long one or short one. The rising costs of nursing care, services, and pharmaceuticals culminates in a complex equation for both seniors and their loved ones alike, therefore, it’s important to plan for the associated financial implications well before your visit.
This guide can provide a clear and accessible picture of how to manage the health care costs that come with staying in a skilled nursing facility. Learn more below or find a facility here!
The national average cost of a skilled nursing facility (SNF) depends on how long you or your loved one stays there, the services required, and the location itself. Generally, a stay in a SNF will be shorter as the patient recovers from an injury, surgery, or illness. Compared to a long-term nursing home stay however—which has a daily rate that ranges from $189 in Missouri to $1,196 in Alaska (Genworth Cost of Care Survey)—you can expect to pay a daily rate that is significantly lower than the annual cost of long-term care.
You may also be able to get this short-term stay fully covered by Medicare for further affordability. For example, if a senior needs skilled nursing care for an average of 15 days, Medicare will cover up to 20 days! Past this benefit period, however, the amount you pay is still fortunately manageable at around $175 daily.
The costs of a staying in a SNF covers these services:
Nursing homes are where seniors go for a long-term period of time when they require custodial assistance with activities of daily living on top of handling their individual medical care needs on a frequent (but not necessarily every single day) basis. On the other hand, a skilled nursing facility is more often a temporary solution for seniors to manage a specific medical need or to allow recovery after an injury or illness outside of a hospital. For example, a skilled nursing facility‘s level of care is appropriate when the patient requires skilled rehabilitative therapy at an intensity and frequency of at least five days per week, at least 60 minutes per day, and for less than a few months at a time.
Another difference is that nursing homes have a focus on employing RNs and LPNs to run the long-term care facility. Meanwhile, SNFs employ not just nurses, but also health care providers, doctors, and therapists full-time to handle services such as:
Because it is a permanent residence for seniors, nursing home costs are typically higher than a stint in a skilled nursing facility. There are many subsidized payment options for skilled nursing services— find out more about these below:
Although everyone in the United States who has paid into the system for the minimum required time is eligible for Medicare, it does not cover most long-term care services or personal care like in a nursing home or assisted living facility. It does, however, cover the costs of inpatient hospital services and medically-necessary acute care, including hospital stays, doctor visits, and medication.
More specifically, Medicare pays for:
Certain eligibility requirements must be met in order to get Medicare coverage for the situations mentioned above. Consult LongTermCare.gov for more information.
Those who meet Medicaid program requirements have low incomes and are, in turn, eligible for not just skilled nursing care but long-term care services at home or in a nursing home. The state you live will determine what long-term care and personal care services you are eligible for.
Your in-force life insurance policy may be able to convert into a pre-funded financial account that disburses a monthly benefit to help pay for not just skilled nursing but also home care, assisted living, and hospice. Unlike life insurance, this account is a Medicaid qualified asset.
Medigap is Medicare Supplement Insurance that is sold by private companies. It can help pay for health care costs that aren’t covered by Medicare, including copayments, deductibles, and coinsurance. Medigap doesn’t typically cover private-duty nursing or long-term care. To be eligible for a Medigap policy, you must have Medicare Part A and Part B. You have to pay the private insurance company a monthly premium for a Medigap policy.
The Department of Veterans Affairs (VA) covers care services for eligible veterans who have limited income and are therefore unable to pay for the cost of care in a skilled nursing facility. Additionally, the VA may also be able to pay for nursing home care and in-home care for aging veterans. There are state programs for long-term care services for older adults and their families. These may include nutrition programs, legal assistance, transportation services, personal care, health promotion services, and family caregiver services.
A personal financial planner is the best person to help explore your personal situation and options. Things to ask a planner include drawing funding from a life insurance policy and credit lines, which allow multiple family members or friends to share the cost of paying for skilled nursing. If you own a house or a car, the proceeds from its sale can go a long way toward paying the cost of senior living while also taking care of a hefty portion of the downsizing process.
No matter what your financial situation is, start planning for the future while you or your loved one are still in good health. If you wait until there is an emergency that requires a stay in a skilled nursing facility, you might be tempted or even forced to take the first option that comes up, no matter what its cost. Our supportive staff are here to help you navigate senior living and find the skilled nursing facility that is best for you or your loved one.