Nursing Home Costs and Payment Options

Two options to pay for soaring nursing home costs are long term care insurance and medicaid. Which is best for you?

-- By K. Gabriel Heiser, Attorney


The annual MetLife Mature Market survey for 2006 was just issued. Here are some of the key findings:

  • The national average rate for a private room in a nursing home is $206/day, which works out to just over $75,000 per year.
  • The national average rate for a semi-private room is $183/day or $66,800/year.
  • The national average hourly rate for home health aides is $19.
  • The national average hourly rate for homemakers/companions is $17.


If you live in Alaska, you'll pay $578 per day for nursing home care! But in Shreveport, LA, it will only cost you $111 per day.


The number of nursing homes in the U.S. now exceeds 1,879,000. Most have between 50 and 200 beds each. The actual number of nursing home residents now exceeds 1,628,000, with approximately 46% at least age 85 and 32% between 75 and 84.


72% of nursing home residents are women. That means they outnumber the men by 2.6-to-1.


The average length of stay in a nursing home is just under 2.5 years. 28% reside there for less than 6 months, 30% for 1-3 years, 13% for 3-5 years, and 14% for 5 or more years.


As you can see from the above statistics, nursing home costs continue to escalate, while the need for them continues to grow as the population lives longer. As the report indicates, in 1980 only 1% of the nursing home population consisted of those over age 85; in 2006, it is over 1.5%. Thank the medical establishment for keeping us alive longer, but the result of that longevity is not always independent living. Many of us will need assistance in our later years.


You should consider purchasing long-term care insurance. Meet with a specialist who knows all the options and works with a number of companies, so you can obtain a number of competing quotes. You may be surprised to find out that your total dollar outlay is less if you purchase a policy today than if you wait and purchase a policy ten years from now. This may seem counter-intuitive, since you'd save the money you'd otherwise have spent for premiums for that ten years, but the higher cost of starting coverage in ten years quickly outpaces the savings, based on a normal life expectancy. Be sure your agent can run some of these projections for you; it's a real eye-opener!


Yes, Medicaid can pay for your nursing home care, as a means of last resort. But the coverage is much more limited, and no one can predict how long and how well Medicaid coverage will continue. It's already a huge proportion of the state and federal budgets. Just as IRAs are replacing reliance on Social Security, the time may be here for people to self-insure with long-term care insurance (LTCI) when the future of Medicaid is in the balance. Of course, if you cannot qualify for LTCI or simply cannot afford it, then you need to plan for Medicaid coverage. Otherwise, take a look at LTCI---you may be glad you did!


K. Gabriel Heiser is an attorney with over 25 years experience in elder law and estate planning. Heiser is the author of “How to Protect Your Family's Assets from Devastating Nursing Home Costs: Medicaid Secrets,” an annually updated practical guide for the layperson. For more information about this book, visit Medicaid Secrets.


Here’s an article about How to buy long term care insurance


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