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After you turn 65, there’s a 70% chance you’ll need some form of long-term care for the rest of your life, according to LongTermCare.gov (1).
Unfortunately, paying for this care can be very difficult: according to SeniorLiving.org, the average price of a semi-private room in a nursing home is $114,665 per year as of 2025 (2).
Let’s say your 80-year-old mother spent a month in the hospital and was sent to a skilled nursing facility because she is unable to manage on her own.
However, her insurance claims she doesn’t need the care and the nursing home wants to take all of her Social Security and pension checks to pay the bills.
Even if your mother has bills to pay, pre-illness loans, and a home she wants to care for after she leaves the care facility, can the nursing home take that money?
Here’s what you need to know.
The first thing to know is that Medicare is likely your mother’s insurer, as it covers most Americans 65 and older.
If your mother chooses a Medicare Advantage plan, it will be administered by a private insurer, and it should cover everything that Medicare does.
Medicare does not cover routine nursing care (called custodial care) for those who cannot perform basic life activities. Medicare covers up to 100 days of skilled nursing care, but only in limited circumstances, such as when you’ve just left the hospital.
Because your mother has just left the hospital, you can appeal the denial of skilled nursing care. If her doctor or care provider believes your mother needs professional care, you should see if they support your efforts to file an appeal with Medicare.
Medicare has information on how you can appeal a denial of coverage.
If your appeal is unsuccessful, your mother will be considered a private pay patient. While she will not forfeit her benefits, she will be billed for nursing home care and expected to pay the bills. Nursing homes usually have upfront bills, so she has to cover her costs to keep her place.
If your mother can’t pay, the nursing home can ask her to leave with “reasonable and appropriate notice” if she’s not in the process of applying for Medicare or Medicaid.
Medicaid pays for nursing care, but she must qualify, meaning she cannot have more than $2,000 in countable assets or resources.
Once she’s on Medicaid, she’ll need to send her Social Security checks to the nursing home, minus the small individual-needs allowance and other insurance premiums she pays.
So, unfortunately, under current rules, the nursing home can take almost all of your mom’s money to cover her skilled care if she doesn’t succeed in appealing and getting Medicare, but she still needs to be at home.
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The best thing to do to avoid this from happening is to prepare for the eventuality of moving into a nursing home by purchasing long-term care insurance.
Long-term care insurance provides coverage for the costs of in-home assistance, nursing homes or assisted living facilities.
Without proper planning, paying for long-term care can deplete your retirement funds. In many cases, the burden of paying for care often falls on family members—potentially straining their finances.
When considering long-term care insurance, GoldenCare offers a variety of options based on your needs, including annuities, short-term care, extended care, home health care, assisted living and traditional long-term care insurance with hybrid life or long-term care benefits.
You can always choose to speak with an elder law attorney to help you appeal a Medicare denial or see what can be done to protect your mother’s assets, but nursing home planning usually needs to be started long before the time care is needed.
If your mom’s benefit checks are enough to cover the nursing home, and if you can make payments on her other debts and her mortgage in forbearance, that may be your best bet if the situation is truly temporary and she hopes to return home.
If nursing home costs are high and she cannot afford the fees, finding a home health aide may also be an option.
With such strict regulations surrounding long-term care, it is important that older Americans have a strong financial cushion for their later years to help them manage the costs of long-term care. Starting early is key, but you can start small.
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LongTermCare.gov (1); SeniorLiving.org (2)
This article provides information only and should not be construed as advice. It is provided without warranty of any kind.
