Families considering long-term care for seniors need to watch for price changes as costs of care And while the most expensive nursing homes seem to be clustered in the north and northeast, the cheapest states for health care are practically in the south. In essence, your doctor must determine that your health is at risk if you do not have access to intermediate or skilled nursing care. The “Medicaid reimbursement rate” is the amount that a state Medicaid program pays to the same nursing home for the same room. Seniors can also access excellent nursing care, with more than 1,200 nursing home centers in the state serving more than 400,000 Californians annually.
Many seniors who are planning their long-term care already know where they want to live, whether it's their current location or a new place to retire, while others might consider the costs of care when planning their future residency. This program also provides assistance to people who currently reside in nursing facilities and want to return home. In order for Medi-Cal to pay for a nursing home stay, your treating doctor must prescribe a nursing home because you need the continuous and permanent availability of specialized nursing care or what is called intermediate care. Medi-Cal covers medically necessary home health services, such as skilled nursing care and medical equipment.
To qualify for Medi-Cal, seniors must reside in a skilled nursing facility or meet income limits. At this time, California has chosen to make services available to some seniors and people with disabilities who live in Sacramento, San Joaquin, Los Angeles, Sonoma, Fresno, San Bernardino, Contra Costa, Alameda, San Diego, Riverside, Kern, Orange, Santa Clara, and San Mateo counties. The cost of private-room nursing homes and semi-private nursing homes in those states is also included in the rankings. The reimbursement rate for Medicaid for nursing home care is approximately 70% of what a private payer pays.
Unless there is a medical need for a private room in a nursing home, Medicaid will only pay for a shared room. Long-term care, such as nursing homes, assisted living facilities, and home care, is expensive, and private health insurance policies generally don't cover those services Nursing homes provide skilled nursing care 24 hours a day for seniors who require more supervision and medical care that could be provided by an assisted living facility. It helps people who are eligible for nursing home care, but would prefer to live in an assisted living community. However, in California, to help with the costs of assisted living facilities, the state has created a Medi-Cal program called the Assisted Living Exemption (ALW) that pays for ALFs in some counties.
