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Three Common Myths About Paying For Nursing Home Care

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The possibility of nursing home placement terrifies many seniors and their families. The specter of loss of control and dignity is part of the problem, but financial concerns may also be overwhelming. It does not help that accurate information is so difficult to obtain. Myths about nursing home costs, long term care insurance and government benefits persist, making the situation more frightening and difficult.

Remembering that Arizona law may differ from that of other states (and, of course, from the systems in other countries), a few of the more common myths about nursing home costs include:

Myth: Long term care insurance is too expensive, and is only for the elderly anyway.

For many people, long term care insurance is the best choice for protecting against the exhaustion of assets required to qualify for government assistance with nursing home care. Although premiums can be expensive, the cost for younger applicants is dramatically lower. The average long term care insurance purchaser is in his or her late 60s or early 70s, but financial advisers recommend that insurance be considered by those twenty years younger.

Myth: Medicare will take care of my medical care if I should need to go to a nursing home.

Medicare is an extensive federal government program providing medical care to the elderly and disabled. Most American citizens and resident aliens over age 65 qualify for its excellent coverage. But Medicare’s nursing home benefit is almost entirely illusory.

Many Medicare beneficiaries believe that the program covers 100 days of nursing home care. But only the first 20 days are fully covered; the next 80 days require the patient to pay the first $96 of care each day. The program also limits its coverage to care which leads to improvement. In other words, once it is clear that the patient will not be likely to return home, Medicare coverage will end.

Medicare supplemental insurance policies and Medicare HMOs may help some nursing home residents. But neither kind of plan increases the length of coverage–most simply provide for the payment of the $96 per day charged to the beneficiary.

Myth: If either my spouse or I enter the nursing home, we will lose our home.

Neither the nursing home nor the government has any ability to “take” the home of a nursing home resident. If no long term care insurance is in place, and the patient does not qualify for Medicaid, the nursing home will expect to be paid each month. That does not mean, however, that the nursing home can “take” away the home–in fact, one’s homestead is exempt from the claims of unsecured creditors including the nursing home.

Once assets (and income) are diminished, the patient may qualify for Medicaid. If the patient’s spouse is still living in the home, Medicaid is not permitted to count the home as an available asset, and may not seek to recover the cost of care it provides by forcing sale of the home (or any other asset, for that matter). If the patient is not married, Medicaid may not force the sale of the home until after the death of the recipient, and even then only in some circumstances.

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Robert B. Fleming


Robert Fleming is a Fellow of both the American College of Trust and Estate Counsel and the National Academy of Elder Law Attorneys. He has been certified as a Specialist in Estate and Trust Law by the State Bar of Arizona‘s Board of Legal Specialization, and he is also a Certified Elder Law Attorney by the National Elder Law Foundation. Robert has a long history of involvement in local, state and national organizations. He is most proud of his instrumental involvement in the Special Needs Alliance, the premier national organization for lawyers dealing with special needs trusts and planning.

Robert has two adult children, two young grandchildren and a wife of over fifty years. He is devoted to all of them. He is also very fond of Rosalind Franklin (his office companion corgi), and his homebound cat Muninn. He just likes people, their pets and their stories.

Elizabeth N.R. Friman


Elizabeth Noble Rollings Friman is a principal and licensed fiduciary at Fleming & Curti, PLC. Elizabeth enjoys estate planning and helping families navigate trust and probate administrations. She is passionate about the fiduciary work that she performs as a trustee, personal representative, guardian, and conservator. Elizabeth works with CPAs, financial professionals, case managers, and medical providers to tailor solutions to complex family challenges. Elizabeth is often called upon to serve as a neutral party so that families can avoid protracted legal conflict. Elizabeth relies on the expertise of her team at Fleming & Curti, and as the Firm approaches its third decade, she is proud of the culture of care and consideration that the Firm embodies. Finding workable solutions to sensitive and complex family challenges is something that Elizabeth and the Fleming & Curti team do well.

Amy F. Matheson


Amy Farrell Matheson has worked as an attorney at Fleming & Curti since 2006. A member of the Southern Arizona Estate Planning Council, she is primarily responsible for estate planning and probate matters.

Amy graduated from Wellesley College with a double major in political science and English. She is an honors graduate of Suffolk University Law School and has been admitted to practice in Arizona, Massachusetts, New York, and the District of Columbia.

Prior to joining Fleming & Curti, Amy worked for American Public Television in Boston, and with the international trade group at White & Case, LLP, in Washington, D.C.

Amy’s husband, Tom, is an astronomer at NOIRLab and the Head of Time Domain Services, whose main project is ANTARES. Sadly, this does not involve actual time travel. Amy’s twin daughters are high school students; Finn, her Irish Red and White Setter, remains a puppy at heart.

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Matthew M. Mansour


Matthew is a law clerk who recently earned his law degree from the University of Arizona James E. Rogers College of Law. His undergraduate degree is in psychology from the University of California, Santa Barbara. Matthew has had a passion for advocacy in the Tucson community since his time as a law student representative in the Workers’ Rights Clinic. He also has worked in both the Pima County Attorney’s Office and the Pima County Public Defender’s Office. He enjoys playing basketball, caring for his cat, and listening to audiobooks narrated by the authors.