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Why many aging adults need Medicaid for nursing home care

On Behalf of | Dec 3, 2023 | Medicaid & Medicare |

Once people reach retirement age, they can qualify for Medicare insurance. Medicare and supplemental health insurance policies can cover the cost of the basic medical needs of older adults during their retirement years. Most people assume that Medicare coverage is enough to manage their care needs as they age. However, Medicare does not necessarily cover more significant health issues.

For example, Medicare does not cover the cost of in-home nursing support or a room in a nursing home. Older adults with increasing medical support needs may eventually realize that neither Medicare nor their personal resources are enough to cover their care costs. They may then need to apply for Medicaid coverage. Those preparing for retirement can help protect themselves from future hardship by planning ahead to more easily qualify for Health First Colorado if they need it later in life.

Long-term care can be prohibitively expensive

While many people plan their retirement savings based on the cost of aging in place, some people will eventually need to move into a nursing home. The cost to pay for a room in a nursing home can quickly burn through whatever savings someone still has at that point. Nursing home costs in Colorado are quite high. A private room costs an average of $10,318 each month, while a semi-private room costs $9,089.

The average person will spend several years in a nursing home, and they probably won’t have enough personal resources to cover their costs. Medicaid or Health First Colorado will cover those costs if someone qualifies. The application process involves a review of both someone’s current income and their personal resources. Assets other than someone’s primary residence can potentially prevent them from qualifying even if they have very little or no income.

Advance planning helps ensure that someone in need of Medicaid benefits won’t be at risk of a penalty that would consume their resources and delay their eligibility for Medicaid benefits. Those preparing for retirement would often benefit from planning for long-term care needs. Ultimately, advance Medicaid planning, including creating a trust, can take some of the stress out of applying for Medicaid if someone requires nursing home care or other support later in life.