Know the risks of private payment for New York nursing home care

On Behalf of | Aug 30, 2021 | Elder Law And Nursing Home Issues |

In New York State, people who have an elderly or infirm loved one who needs extensive care must consider alternatives. A nursing home is a viable option to provide the person with the attention, medical treatment and assistance they need. However, paying for it is always a concern. Some might think about paying for it privately to avoid the complexities of going through insurance or using Medicare or Medicaid. This might be a mistake and it is important to know the facts about private payment.

Rates and realities of paying out of pocket for nursing home care

Most people do not have the assets to pay for nursing home care on their own. Therefore, they use some form of insurance. Even those who might have the assets should hesitate before paying out of pocket. In a nursing home, there are daily rates for the services that residents are given. The facility itself will determine how it charges. For example, there might be an all-inclusive plan or there could be separate charges for the room, food and physician’s treatment. In general, facilities are unregulated in how much they charge. With that, the fees will be whatever the facility decides.

Even people who have written details of the agreement, fee schedules and charges can be surprised by sudden escalations and unexpected charges. When there is a rate increase, the facility is legally bound to give written notification 30 days before it begins. These facilities can also ask for a security deposit or to be paid before the person moves in. In many instances, people who do have the funds to pay out of pocket will quickly drain their resources and need to use some form of insurance. Often, that is Medicaid. Some nursing homes do not even accept Medicaid, so this should also be understood before moving forward.

Consider alternatives before paying the nursing home directly

It is against the law for a person to be removed from a facility because he or she no longer has the resources to pay for it. Failure to pay for the care and other charges from a nursing home can result in being transferred to discharged. These potential challenges make it imperative to know about nursing home planning and insurance. People frequently make the mistake of not knowing that they can use Medicare or Medicaid to pay for nursing home care or they are not sure of how much is covered. When making plans to place a loved one in a nursing home, it may be useful to have experienced advice on how to pay for it without exhausting assets.