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Once you turn 65, there is a 70% chance that you will need some type of long-term care for the rest of your life, according to LongTermCare.gov (1).
Unfortunately, paying for this care can be very difficult: according to SeniorLiving.org, the average price of a semi-private room in a nursing home is $114,665 per year in 2025 (2).
Let’s say your 80-year-old mother spent a month in the hospital and was sent to a skilled nursing facility because she can’t manage on her own.
However, your insurance says you don’t need care, and the nursing home wants to keep all of your Social Security and pension checks to pay the bills.
Can the nursing home accept that money, even though your mother has bills to pay, debts she incurred before she got sick, and a home she wants to maintain after leaving the care facility?
Here’s what you need to know.
The first thing you should know is that Medicare is probably your mother’s insurer, since it covers most Americans over 65.
If your mother has chosen a Medicare Advantage plan, it will be administered by a private insurer and must cover everything that Medicare covers.
Medicare never covers routine nursing care (called custodial care) for those who cannot perform basic living tasks. Medicare covers skilled nursing care for up to 100 days, but only in limited circumstances, such as when you just leave the hospital.
Since your mother just left the hospital, you may want to appeal the denial of skilled nursing care. If your doctor or care provider believes your mother needs professional care, you should see if they will support your efforts to file an appeal with Medicare.
Medicare has information about how you can appeal a denial to try to get coverage.
If her appeal is unsuccessful, her mother will be considered a private paying patient. While your benefits will not be seized, you will be billed for nursing home care and will be expected to pay the bills. Nursing homes typically bill in advance, so she will have to cover the costs to keep her place.
If your mother cannot pay, the nursing home may ask her to leave with “reasonable and appropriate notice” if she is not in the process of applying for Medicare or Medicaid.
Medicaid pays for nursing care, but she has to qualify, which means she cannot have countable assets or resources greater than $2,000.
Once you have Medicaid, you will be required to send your Social Security checks to the nursing home, minus a small personal needs allowance and minus any other insurance premiums you may be paying.
So, unfortunately, under current rules, the nursing home can take almost all of your mother’s money if she fails to appeal and get Medicare to cover her skilled care, but she still needs to be in a home.
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The best thing you can do to prevent this from happening is to be prepared for the possibility of entering a nursing home by purchasing long-term care insurance.
Long-term care insurance offers coverage for the costs of home care, nursing homes, or assisted living facilities.
Without proper planning, paying for long-term care could deplete your retirement fund. In many cases, the burden of paying for care often falls on family members, which could strain their finances.
When considering long-term care insurance, GoldenCare offers different options depending on your needs, including hybrid life or annuity with long-term care benefits, short-term care, extended care, home health care, assisted living, and traditional long-term care insurance.
You can always choose to speak with an elder law attorney to help you appeal a Medicare denial or see what can be done to protect your mother’s assets, but planning for a nursing home usually needs to begin long before care is needed.
If your mother’s benefit checks are large enough to cover the nursing home, and if you can stop payments on her other debt and her mortgage, that may be your best option if the situation is truly temporary and she hopes to return home.
If the nursing home costs too much and she cannot afford the fees, finding a home health aide could also be an option.
With such strict rules surrounding long-term care, it is critical that older Americans have a solid financial cushion for their later years to help them manage the cost of long-term care. Starting early is key, but you can also start small.
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LongTermCare.gov (1); SeniorLiving.org (2)
This article provides information only and should not be construed as advice. It is provided without warranty of any kind.
