Your loved one needs help with daily activities and health care support, but you’re concerned about your family’s ability to pay. Given that over 15 million seniors in the U.S. live on less than $26,000 a year, this concern is becoming increasingly common as senior care costs rise. Fortunately, there are several options your family can explore to make sure your loved one receives the care they need to age safely in a nursing home, including federally funded insurance programs, supplemental income, and state benefits.
Our free tool provides options, advice, and next steps based on your unique situation.
The median U.S. cost of a private room in a nursing home was $9,034 in 2021, while a semi-private room cost $7,908 a month, according to Genworth’s most recent Cost of Care Survey.[01] Because of the high level of care they provide, nursing homes are also generally the most expensive senior housing option.
Nursing homes are designed for older adults with significant physical or mental health conditions that require 24-hour nursing or personal care. They offer a higher level of care than other types of senior living communities, such as assisted living or memory care, but not as much care as a hospital stay. They also offer custodial care — assistance with activities of daily living (ADLs), such as bathing, dressing, and using the toilet — as well as activities, therapies, and other amenities.
Nursing home care may seem out of reach for seniors with limited funds, but a variety of government-sponsored programs and private insurance options can help your family pay for a nursing home. Whether your loved one needs immediate rehabilitative care due to an illness or injury, is looking for a residential environment where they can age safely long-term, or is just beginning to explore future care possibilities, knowing your options can help you make the right senior living decision.
Below, we’ll explore the following resources:
Medicare is a federally funded insurance program for seniors over 65, as well as younger people with certain disabilities. Medicare won’t cover long-term nursing home stays, but it can be used for short-term skilled nursing care after an injury or illness.
Medicare Part A, also known as Hospital Insurance, will cover a rehabilitative stay and rehabilitative services in a nursing home for up to 100 days. However, starting at day 20, families might have to pay up to $200 each day in coinsurance costs.[02] Medicare may also cover hospice stays, as determined by a doctor.
To qualify for 100 days of care in a nursing home under Medicare, even with a copay, a senior must:
After day 100, Medicare’s coverage of nursing home payments stops. If your loved one needs to stay in the nursing home longer, whether they choose to move in for a long-term stay or simply require more rehabilitation, they’ll have to rely on other resources to pay for care.[02]
Our free tool provides options, advice, and next steps based on your unique situation.
Even after 100 days, Medicare may cover some aspects of your loved one’s nursing home care. For example, it may pay for injury-related physical therapy, wound care, or injections, but it won’t pay for ADL assistance, monthly rent, or amenity fees.[02]
| Service | Will Medicare pay? |
|---|---|
| 100 days of skilled nursing services | Yes, with coinsurance payments after day 20 |
| Assistance with ADLs, like dressing, bathing, and using the toilet | No |
| Injury-related physical therapy | Yes |
| Wound care | Yes |
| Insulin injections | Yes |
| Monthly rent costs | No |
| Activity or amenity fees | No |
| On-site visits from doctors | Yes |
| Transportation | No |
| Meals | No |
Medicaid and Medicare may sound similar, but they’re very different types of insurance. Because of that, they contribute different amounts to nursing home care. Medicaid is sponsored jointly by federal and state governments and is available to eligible low-income adults. Eligibility requirements vary by state.
Unlike Medicare, Medicaid pays for long-term nursing home care for all seniors who meet program requirements. Depending on the state where your loved one lives, Medicaid representatives will analyze their income, assets, medical criteria, and five-year spending history to determine if they’re eligible for the program.
If a senior is approved for Medicaid, they’ll pay an income-based coinsurance amount to secure care. Medicaid will then cover the majority of nursing home costs, including room and board, meals, scheduled activities, assistance with ADLs, and health care needs.
Federal requirements state that Medicaid recipients won’t be charged for the following in nursing homes:[03]
Seniors with Medicaid may have to pay extra if they wish to have a private room that isn’t medically necessary, participate in activities separate from those on a standard social calendar, or request special meals based on dietary preferences or religion — such as vegan, kosher, or gluten-free meals — rather than on medical restrictions.
Read more:Medicare, Medicaid, and Long-Term Care
The Department of Veterans Affairs (VA) and Veterans Health Administration provide VA benefits and other government programs that can help qualifying veterans and their families pay for nursing home care.
Veterans enrolled in VA health care services may be eligible for several financial benefits, including:
Pension money can be used however a veteran chooses, while Aid and Attendance benefits are designed specifically to be used for senior living, long-term care, and caregiver support.
The VA provides three options for nursing home care, and all three of these options offer medical care and 24-hour supervision and ADL assistance:[07]
If your loved one prefers not to age in a Community Living Center or other nursing home, they may qualify for the Housebound benefit, which is available to eligible veterans or their surviving spouses who are confined to their homes and unable to leave without assistance due to a permanent disability.[06]
It’s important to note that a veteran can’t receive Aid and Attendance benefits and a Housebound allowance at the same time.
Social Security benefits make up almost 50% of post-retirement earnings for seniors over the age of 60. Unlike the insurance benefits listed above, which pay for specific medical and custodial care needs, Social Security can be used at the senior’s discretion, just like any other money.
Your loved one’s state of residence, housing situation, personal assets, and pre-retirement income all affect their Social Security benefits. The Social Security Administration offers two main types of benefits, which have different financial eligibility requirements. Some seniors qualify for both types of benefit.[08]
Social Security benefits are based on a person’s pre-retirement earnings, and are paid into by employee and employer contributions over the years. The average monthly Social Security benefit in 2023 is $1,691.53.
Supplemental Security Income (SSI) benefits are designed for lower-income adults who aren’t eligible for disability benefits but may not have garnered significant enough wages throughout their working lives to receive sufficient Social Security benefits. The average SSI benefit for seniors in 2023 is $553.94 a month.
So does Social Security pay for nursing home stays? Not directly. It generally won’t cover the full cost of a nursing home, but it can contribute greatly to your loved one’s funds. Since Social Security and SSI benefits basically work like bank deposits, you can put that money toward nursing home rent or any other care needs.
A nursing home may be the best option for your loved one with limited income, but it depends on the type of care they need. Here’s a breakdown of other senior living options and how the resources listed above can help your family pay.
Assisted living communities are designed to help seniors with some physical limitations remain independent and active for as long as possible. They offer help with ADLs, scheduled activities, meals, and light housekeeping in a residential environment.
Many of the ways to pay for assisted living with no money are the same as those listed above, with the key exception of Medicaid. While Medicaid will cover most nursing home costs for eligible seniors, it will only pay for the medical aspects of assisted living, not custodial care, rent, or ADL assistance.
Memory care communities can help seniors with Alzheimer’s disease or another type of dementia age safely in a supportive, residential setting. They offer therapies and activities designed to slow the progress of cognitive decline, as well as help with ADLs, nutritious meals, and 24-hour safety monitoring.
Memory care facilities can be stand-alone or they can be designated wings of an assisted living community. As such, Medicare and Medicaid may cover some costs and services in memory care communities.
VA memory care options may offer your loved one extra financial assistance if they’re a veteran experiencing cognitive decline.
If your loved one has been diagnosed with a terminal illness and a doctor has determined they have six or fewer months to live, they’ll likely qualify for hospice care. For seniors who’ve chosen to stop treatment for their illness, hospice is designed to keep them comfortable by providing pain management, assistance with daily activities, care coordination, and counseling.
Hospice care is generally free for qualifying families. Medicare covers hospice costs without a deductible, though there may be small copayments for medications. However, it’s worth noting that hospice care through Medicare doesn’t cover the cost of a living space (for example, renting your home or assisted living apartment). The VA and Medicaid provide hospice coverage as well, and they may cover the cost of living in a certified facility.[09]
Our advisors help 300,000 families each year find the right senior care for their loved ones.
The department of Housing and Urban Development (HUD) doesn’t pay for nursing homes or other senior living facilities, but it can help eligible lower-income seniors secure housing and care. HUD offers three main rental assistance programs that allow older adults to choose between government housing options that best fit their needs. Keep in mind that there’s often a waiting list for HUD-approved residential buildings.
It’s common for someone who owns or has rented the home they’ve lived in for years to not want to move into a senior living community or other care facility. If they rent and their landlord is amenable to accepting housing choice vouchers, they may be able to qualify for HUD assistance that helps them with monthly rent payments.
If your relative wants to age in a familiar residential environment, but remaining in their own home isn’t affordable or accessible, you could consider moving them into your house or the house of another family member.
Moving a senior loved one who can’t pay for care into your home may seem like a simple solution — and in some situations, it can be. However, depending on the level of care your relative needs, becoming a family caregiver can be both financially and emotionally difficult. In addition to adjusting to living with your parent, you may have to make home modifications to ensure their safety. Make sure you fully consider the impact of moving a family member in with you before making a decision.
If they’re a veteran, your relative may qualify for the Housebound benefit described above, or Home Based Primary Care, which offers in-home support for ongoing medical conditions, as well as ADL assistance.
Medicaid waivers, which are offered by individual states rather than the federal government, may be used to pay for supportive services, depending on the state where your loved one lives. An in-home caregiver can help with ADLs, provide transportation, and offer companionship. The Medicaid Home and Community Based Service waiver and Program of All-Inclusive Care for the Elderly are the most commonly available waivers that can help your qualifying loved one age at home.[12]
Pensions, savings, and Social Security income can also be used to pay for in-home care or home health care.
| Type of senior Care | Social Security* | Supplemental Security Income* | Medicare | Medicaid | VA benefits | Department of Housing and Urban Development |
|---|---|---|---|---|---|---|
| Nursing homes | 18% | 6% | Pays for medical, but not custodial, aspects of nursing homes | Yes | Yes | No |
| Assisted living | 38% | 12% | Pays for medical, but not custodial, aspects of assisted living | May pay for medical needs and some custodial care services, depending upon income and state of residence | Pensions and Aid and Attendance benefits can be put toward assisted living care costs | Sections 202 and 811 offer similar services to assisted living communities, often with lower-level care |
| Memory care | 31% | 10% | Pays for medical, but not custodial, aspects of memory care | Memory care provided in a nursing home is covered | Pensions and Aid and Attendance benefits can be used to fund memory care | No |
| Aging at home | Can be put toward rent payments, or used for 63 hours of home care a month | Can be put toward rent payments, or used for 22 hours of home care a month | Medical supplies and devices can be purchased with Medicare funds | Medicaid HCBS waivers can offset the costs of aging at home | Qualifying veterans can receive the Housebound benefit | Yes |
| Hospice care | Not needed | Not needed | Yes | Yes | Yes | No |
| Living with family | Can be used to cover family or health care needs | Can be used to cover family or health care needs | Medical supplies and devices can be purchased with Medicare funds | Medicaid HCBS waivers can offset the costs of family caregiving | Veteran Directed Care programs allow seniors to choose their own care provider, including family | Yes |
*The percentages in these columns are based on national average Social Security payments of $1,691.53 a month and national average SSI payments of $553.94 a month [08] as compared to national median costs of nursing homes, assisted living, and memory care at $8,910, $4,500, and $5,430 a month, respectively.[01,13]
If your loved one needs care as they age, it’s helpful to plan ahead as much as possible. Consider your family’s budget: Does your relative have any savings or receive regular pension payments? Do they have assets like a home, stocks, or bonds that could be sold to pay for care?
Next, think about the options above that may be available to your loved one. Medicare is offered to all U.S. seniors over 65 if they apply, and Medicaid may be available depending on your family’s financial situation. If your relative is a veteran, they can work with the VA to secure funding for care.
If you aren’t sure where to start, reach out to one of A Place for Mom’s Senior Living Advisors. They can help you explore different senior housing options, discuss your family’s budget and assets, and offer more information about the programs above, all at no cost to you.
Key Takeaways
Genworth. (2022, June 2).Cost of Care Survey.
Centers for Medicare & Medicaid Services. Skilled nursing facility (SNF) care.
Centers for Medicare & Medicaid Services. Nursing facilities.
U.S. Department of Veterans Affairs. (2022, October 12). VA survivors pension.
USAGov. (2023, January 18). Military pay and pensions.
U.S. Department of Veterans Affairs. (2022, October 12). VA Aid and Attendance benefits and Housebound allowance.
U.S. Department of Veterans Affairs. (2022, October 12). VA nursing homes, assisted living, and home health care.
Center on Budget and Policy Priorities. (2022, March 4). Policy basics: Top ten facts about Social Security.
Centers for Medicare & Medicaid Services. (2022, March 14). Hospice.
U.S. Department of Housing and Urban Development. Section 202 supportive housing for the elderly program.
U.S. Department of Housing and Urban Development. Housing choice vouchers fact sheet.
Musumeci, M., Chidambaram, P., & O’Malley Watts, M. (2019, April 4). Key questions about Medicaid Home and Community-Based Services waiver waiting lists. Kaiser Family Foundation.
A Place for Mom. (2022). Senior Living Price Index.
The information contained on this page is for informational purposes only and is not intended to constitute medical, legal or financial advice or create a professional relationship between A Place for Mom and the reader. Always seek the advice of your health care provider, attorney or financial advisor with respect to any particular matter, and do not act or refrain from acting on the basis of anything you have read on this site. Links to third-party websites are only for the convenience of the reader; A Place for Mom does not endorse the contents of the third-party sites.
Make the best senior care decision