Nursing Home Bill Blues? How You May Qualify for Payment

Yes, you or your loved one may qualify for payment of nursing home care.

Understanding the rules and proper legal planning within the rules may help you understand about options that may pay your nursing home bill.  

Who pays for nursing home care? Medicare and Medicaid are different programs offering different solutions.

  • Medicaid pays for nursing home care for qualified men and women and pays for health care for qualified low-income individuals.
  • Medicare provides health insurance for people age 65 and over.

Good news! You can qualify for both programs at the same time, known as “dual eligibility.”

There are about 11 million people who are dual eligible, including many seniors who need nursing home care or are already in nursing homes.

Working with an attorney focused on elder law may help you make proper legal arrangements to

How To Qualify for Medicaid Nursing Home Benefits and Medicare Health Insurance

Medicare Qualification: Anyone qualified for Social Security benefits (retirement or disability) is eligible for Medicare. Remember, Medicare is health insurance for those age 65 or older.

Medicaid Qualification: People with specific income and resources are eligible for Medicaid, including paying for nursing home services. 

Proper legal planning for nursing home qualification may make a difference in keeping your home, car, etc.
At first glance at the qualification table below, you may assume very few assets can be retained by a healthy spouse and still allow the dependent spouse to qualify for Medicaid nursing home care. In many situations, proper legal planning provides protection of family assets.

Every case is different. We’ll be glad to visit with you about your situation. 

More Medicare & Medicaid Benefits

There are also different levels of Medicare and Medicaid coverage, so a person who is dual-eligible may fall into one of these four categories:

  • Qualified Medicare beneficiaries may pay for Part A and Part B premiums, deductibles, copayments and coinsurance.
  • Specified low-income Medicare beneficiaries have their Part B premiums covered by Medicaid.
  • Qualifying individuals may also receive help from Medicaid for their Part B premiums.
  • Qualified disabled working individuals may have their Part A premiums covered by Medicaid. This program is limited to individuals with disabilities who are working.

As we described earlier in this article, in many cases, nursing home care can be provided through Medicaid for a husband or wife and the more physically able spouse can maintain a level of financial independence. Give us a call at 817-638-9016 to set up an appointment with Travis Weaver or Rick Weaver — both are elder care-focused attorneys at Weaver Firm – Attorneys. Rick is also board certified by the State Bar of Texas in the area of estate planning and probate law.


Travis Weaver, Attorney Focused on Elder Care