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Patricia Clark, now 86, went into the hospital about four years ago for a hip replacement. Patricia had had health problems over the years, but was doing well at the time, except that her declining mobility was making it increasingly difficult to live independently. Her doctors expected her to fare better with a new hip. Unfortunately, Patricia suffered a debilitating stroke in surgery and was left unable to get around on her own or live at home by herself. She was admitted to a rehabilitation center but did not improve, and now she lives there as a nursing home resident. Medicare pays for most medical care that Patricia needs, but Medicaid pays for her nursing home care
Medicaid is the primary payer for long-term care for over 3 million Americans. Medicaid covers care provided in institutional settings, such as nursing homes, for beneficiaries like Patricia. The program also covers a range of home- and community-based services that Medicare and private insurance exclude or tightly limit, enabling many people who would otherwise require nursing home care to live independently in the community. Paying for long-term services is expensive and can quickly exhaust lifetime savings. The cost of nursing home care averages $72,000 per year; the average cost for assisted living facilities is $38,000 per year; and home health services cost $21 per hour, on average.
"She's very content here…but she would not have any of this without Medicaid, honestly. It would be a disaster for her." – Patricia's daughter, Jill