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Does Medicaid Help Pay for Nursing Homes, and Other Long-Term Care?


December 03, 2018 0):?> in: Senior Finances Uncategorized

“What is Medicaid?” People who aren’t aware of this term should know this medical program. It runs on a shared basis by the state and federal institutes in the United States. The aim is to assist the medical cost of those with budget constraints and limited resources.

People who want to consider nursing homes but can’t financially afford it should look into Medicaid. Here’s an explanation of their services in detail:

Offers Personal Services

Generally, Medicaid nursing home is chosen when you need financial assistance for your medical care. However, assisted living services and nursing homes are long-term care options. And long-term care includes both medical services as well as personal services. Therefore, Medicaid ensures to offer payment for nursing facilities to participating patients. In other words, Medicaid covers general health facilities, as well as nursing home services. Personal care, nursing care, and therapy sessions are part of the Medicaid nursing home and Medicaid assisted living.

Medicaid Eligibility Criteria

As mentioned above, Medicaid is a great initiative to financially help those who can’t afford a nursing home, assisted living, or any personal services. However, not every nursing home or assisted living facility accepts Medicaid payments. Medicaid needs to be state-licensed and must meet certain federal requirements which are as follows:

1. Financial Eligibility

Every state has its own guidelines, laid down by the SSI program. In the majority of states, you can be eligible for Medicaid nursing home if you can have 300% of the SSI income limit.

However, the income limit depends on the type of long-term care you are looking for. To know if you are qualified for Medicaid nursing home or Medicaid assisted living, you should contact a local Medicaid office.

2. Medical Eligibility

You don’t necessarily have to be elderly to receive Medicaid assistance. There are children and adults – both young and old – who may need nursing home services. In cases like these, they can easily apply for Medicaid assistance. It’s important to make sure the services are elected by the state to be covered by Medicaid.  They must also meet the eligibility criteria.

Does Medicaid Pay for Nursing Homes?

Medicaid in California

In California, nursing homes and assisted living services are costly. Since private health insurance services do not cover these services, Medicaid can be considered for the nursing home payment.

Medicaid in Georgia

Medicaid paying for nursing home expenses is common in Georgia. About 74% of the Georgian population gets Medicaid assistance for payment of their nursing homes.

Medicaid in Illinois

The Medicaid program of Illinois includes sufficient payment for nursing homes and assisted living for the citizens.

Medicaid in Massachusetts

Medicaid is a popular mean to fund for long-term care in Massachusetts. It is especially beneficial to those who have spent their assets to pay for either nursing home or assisted living facility.

Medicaid in New Mexico

According to the folks at seniorplanning.org here are the eligibility criteria in order for long-term care to be covered:

  • The patient must be a resident of New Mexico, and a U.S. citizen, or have proper immigration status.
  • Applicant must be 65 years or older; or blind, or disabled.  And they must need care for thirty days in a row.
  • The income limitations are an important factor.  If the applicant is single, their income cannot be higher than $2,250.  This includes any wages, Social Security benefits, Veteran’s benefits, pensions, SSI payments, IRAa, etc.
  • Finally, asset limitations are taken into consideration.  Basically, if the applicant has assets that are not considered exempt according to Medicaid, they must be liquidated and considered into the applicant’s assets.  The state will go back 5 years to see if any assets were sold below fair market price, transfer assets to others, or give money and property away. If they find any of these types of asset moves, the applicant will be penalized.  See a list of the exempt assets for New Mexico applicants here.

We've only covered a few states, it's best to ask your local Medicaid office to ask for the eligibility details you'd need to meet. 

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