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Once you turn 65, there’s a 70% chance you’ll need some kind of long-term care throughout 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 as of 2025 (2).
Let’s say your 80-year-old mother spent a month in hospital and was sent to a specialist care facility because she can’t care for herself.
However, her insurance claims she does not need care and the nursing home wants to take all her Social Security and pension checks to pay the bills.
Can the nursing home take that money even though your mom has bills to pay, debt she took on before she got sick, and a home she wants to maintain after she leaves the care facility?
Here’s what you need to know.
The first thing to know is that Medicare is probably your mom’s insurer, since it covers most Americans who are 65 and older.
If your mother chose a Medicare Advantage plan, it will be run by a private insurer and must cover everything that Medicare does.
Medicare never covers routine medical care (called custodial care) for those who cannot perform basic life tasks. Medicare covers skilled nursing care for up to 100 days, but only in limited circumstances, such as when you have just left 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 thinks your mother needs professional care, you should see if they will support your efforts to file a Medicare appeal.
Medicare has information about how you can appeal a denial to try to get coverage.
If your appeal is unsuccessful, your mother will be considered a private paying patient. Although her benefits will not be seized, she will be billed for nursing home care and pay the bills. Nursing homes usually bill in advance, so they will need to cover their costs to keep their place.
If your mom can’t pay, the nursing home can ask her to leave with “reasonable and adequate notice” if she’s not in the process of applying for Medicare or Medicaid.
Medicaid pays for medical care, but you must qualify, which means you cannot have assets or countable resources over $2,000.
Once he is on Medicaid, he will be required to send his Social Security checks to the nursing home, minus a small personal allowance and minus any other insurance premiums he may pay.
So unfortunately, under the current rules, the nursing home can take almost all of your mom’s money if she can’t 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 to do to avoid this is to be prepared for the chance of entering a nursing home by purchasing long-term care insurance.
Long-term care insurance provides 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 can strain their finances.
When considering long-term care insurance, GoldenCare offers different options based 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 challenge a Medicare denial or see what can be done to protect your mother’s assets, but nursing home planning usually needs to start well in advance of the caregiving time.
If your mom’s benefit checks are big enough to cover the nursing home, and if you can put payments on her other debt and mortgage into forbearance, this may be your best bet if the situation is truly temporary and she hopes to return home.
If the nursing home costs too much and she can’t afford the fees, looking for a home health aide could also be an option.
With such strict rules around long-term care, it is critical that older Americans have a strong financial cushion for their later years and help them manage the cost of long-term care. Starting early is essential, but you can also start small.
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Invest in real estate without buying property
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All loans are backed by residential homes as collateral, so even if borrowers default, the underlying property can be sold to keep the fund healthy.
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Increasing wealth with gold
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If you are curious if this is the right investment to diversify your portfolio, you can download our free gold and silver information guide today.
LongTermCare.gov (1); SeniorLiving.org (2)
This article provides information only and should not be construed as advice. Offered without warranty of any kind.
