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Due to the high cost of assisted living, nursing home facilities, and at-home long-term care, most people cannot afford to pay for these services out-of-pocket for very long.

The elder law attorneys at Red Oak Legal, P.C., can help families determine how to coordinate private resources with public benefits provided by Medicare, Medicaid, and the VA in order to provide for a loved one’s long-term care needs.

Paying for Long-Term Care

Long-term care is expensive. In Alabama, the average cost of a single month in a nursing home (“skilled nursing facility”) is $6,000 per month

When it comes to paying for long-term care, people generally fall into one of three categories. The first group consists of people who have the resources to pay for the entire cost of their long-term care, whether the money comes from private resources or a long-term care policy.

The second group of people consists of the poor. When an individual has no resources, a means-tested government program like Medicaid will usually pick up the cost of their nursing home care. 

But what about the rest of us? 

A large number of elderly Americans fall somewhere in between: they have too many resources to obtain any government assistance, but too few resources to afford the cost of long-term care for very long. Most in this group are middle-class people who spent a lifetime building a nest egg, only to see it spent down to pay for a few months’ of nursing home care. 

Private Pay 

For nursing home residents with sufficient resources, private payment is always an option. But what if the money runs out?

When a loved one requires nursing home care, don’t wait until the money is almost gone—talk with an attorney who practices in the area of elder law to determine what can be done to protect your loved one’s assets. 


Medicare is a health insurance program for people over 65. It does not cover the cost of long-term nursing home stays. Under the right circumstances, Medicare will cover the full cost of up to 20 days in a skilled nursing facility. However, after day 20, Medicare will only cover a small portion of the cost for days 21-100. Then, after day 100 Medicare will not cover any of the nursing home costs. (Compare Medicare with Medicaid, below). 

Long-Term Care Insurance 

Only a small percentage of people purchase long-term care insurance policies. We usually recommend to our clients that they at least consider purchasing a long-term care insurance policy if they are able to do so.

The benefits provided by a long-term care policy vary widely from company to company. Review your policy every few years to be sure that you understand what benefits your policy does (or does not) provide.


Medicaid is a means-tested program that pays for certain medical expenses for the very poor. Because the cost of nursing home care in Alabama is so expensive, many people who started in the middle class find themselves to be very poor after a few months.

In Alabama, Medicaid will contribute to the cost of nursing home care only if the Medicaid applicant has income and resources (assets) under certain limits.

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