The average monthly cost of a nursing home in the United States is between $8,669 for a semi-private room and $9,733 for a private room. However, costs vary by location, the level of care, and the type of room and amenities.

Factors affecting cost can include:

• Location with the Midwest and the South generally having the lowest median prices. 

• The type of room you choose, whether it’s private or semi-private. 

• Luxury amenities and services you choose can impact the cost. 

• The level of care you need, such as 24-hour care, affects the cost.    

As of July 2024, 63% of nursing facility residents in the United States paid for their care primarily through Medicaid. Medicaid is a joint state and federal health insurance program that helps low-income people pay for long-term care. 

Most Medicaid-covered residents are also eligible for Medicare. Medicare usually covers the first part of a nursing facility stay, and Medicaid covers the rest. 

Medicaid is a critical provider of home- and community-based care, which helps keep seniors at home with their families. 

Medicaid typically pays 100% of nursing home costs if you meet eligibility requirements. However, the amount varies by state and facility. 

Medicaid eligibility, benefits, and coverage vary from state to state. 

Other ways to pay for nursing home care include long-term care insurance, but relatively few people have it. 

Eligibility requirements for Medicaid include the following:

• You must require long-term care;

• Your income and assets must fall below certain state-established levels;

Factors that affect Medicaid payments:

Other things to remember are:

• Countable resources, such as bank accounts, stocks, bonds, and property, must be below certain state-established levels;

• The nursing home must be Medicaid-certified and have designated Medicaid beds;

• You may be allowed to keep a monthly allowance and a deduction for medical needs;

• The amount of the allowance varies depending on your living arrangements, type of nursing facility, and state rules;

• You may be able to exempt certain assets, such as your home, car, personal belongings, and savings for funeral expenses.

Over 7 million seniors rely on Medicaid for nursing home care, according to Justice in Aging. Medicaid is the primary payer for more than six in 10 nursing home residents. 

Medicaid is particularly important for older adults who need help with daily activities, such as eating, dressing and bathing. 

Medicaid covers benefits that Medicare does not, such as dental, vision, hearing, and non-emergency medical transportation. 

Medicaid is jointly financed by states and the federal government, but administered by states.  

With all the good Medicaid does for millions of Americans there is most likely some abuse and fraud of the system. For many years an acquaintance of mine owned a nursing home that falsely billed Medicaid hundreds of thousands of dollars. He was caught and imprisoned over four years. Because there are many who aren’t caught, millions of tax dollars are stolen.

The Department of Government Efficiency hopefully can provide oversight that will eliminate or stop most of the fraud and abuse.

However, this is a critical service for millions of Americans that would be difficult if not impossible for most to be without.

— Dr. Glenn Mollette is read in all 50 states. He may be emailed at gmollette@aol.com.