| Medicaid is a government program that pays for
certain health care services and nursing home care for older people
with low incomes.
Medicaid Coverage and Medicaid Benefits for Nursing Homes and
Community Services
Medicaid coverage includes physician fees, hospital and long term
care costs. Additional coverages include drugs, equipment and transportation.
Medicaid benefits for nursing homes includes room and board and
long term care health services. In most states, Medicaid coverage
also extends to some community and home based long term care services.
Medicaid benefits for community services usually only covers health
care services. Rent, food, utilities and taxes have to be paid by
the recipient out-of-pocket. Medicaid in some state may leave allowances
that are too small and many recipient are forced to go to a nursing
home instead.
Medicaid Eligibility for Nursing Home Expenses
Both federal and state guidelines for income and personal assets
must be met for Medicaid eligibility. If you have substantial income
and assets and still qualify for the program, Medicaid law usually
requires you to spend down your assets on health care each month
before Medicaid pays.
Financial Medicaid eligibility for nursing home and community waiver
may require recipients to be receiving Supplemental Security Income
(SSI) payments. If the recipient is qualifying under alternate income
rules and receive no SSI payment, the recipient can have no more
than $2,000 in resources.
Resources are defined as any asset that can be used to produce
income. Some states may not count your home and a car when determining
Medicaid eligibility. However, Medicaid may subject these non-income
producing assets to estate recovery upon the death of the recipient.
Recipients that gift away their assets are subject to a lookback
period usually within 36 months of a community waiver or nursing
home stay and will be counted as resource. Irrevocable trust assets
created 60 months prior to the nursing home stay will also be counted
as an asset or resource and may be subjected to the spend down requirements.
Each state has different laws about how much money and assets you
can keep and still be eligible for Medicaid benefits. Contact your
state Medicaid office, department on aging or state department of
social services for more specific Medicaid information, Medicaid
requirements and for Medicaid application.
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