Paying for Long Term Care Costs with Medicaid

Posted by: Daniel

Are you looking into the best options for funding long term care for yourself or a loved one? Chances are, if not now, there will come a time in the future when you’ll be seeking real options. Whether they are looking for elderly home care, an assisted living facility, or nursing home care, the majority of Americans will need help to maintain their day to day functions as they age. Ideally, socking away a small fortune to prepare for the inevitable is ideal. However, if this isn’t an option, there are valid alternatives to help fund long term care. In this post, we’ll be focusing on the Medicaid option. The purpose of this blog is to give a basic overview of Medicaid eligibility, benefits, and potential pitfalls.

Medicaid Eligibility

Medicaid is a jointly funded Federal and State program for individuals with low incomes and few resources. Since Medicaid is administered at the state level, eligibility criteria will vary depending on the state in which one lives. As a general rule, Medicaid recipients applying for long term care must meet the following criteria:

• Limited income. Income eligibility criteria will vary from state to state (long term care Medicaid for your State may have a higher income allowance than straight Medicaid).
• Limited assets. Most States limit assets to around $2,000, however an individual may own their home and a vehicle.
• Functional eligibility. In order to be eligible for long term care benefits, applicants must meet a certain criteria. Generally speaking, they must demonstrate that their is a true need for day to day assistance, that renders them unable to remain independent on their own.

To find out your state’s eligibility requirements, call your local Department of Human Services, or look them up online. Applications can almost always be printed from the websites and mailed in for your convenience.

Medicaid Benefits

So what benefits are available once an applicant has been qualified for Medicaid? For those who wish to remain in their homes, most states offer waiver programs which allow for an array of health care professionals to provide home care services to them in their private residences. These services include the provision of Personal Care Attendants, C.N.A.’s and Registered Nurses. Coupled with case management, these services allow for nearly every facet of senior home care to be provided, allowing maximum independence for the recipient. The trend in recent years has shifted towards long term care in a home and community based setting, allowing for both greater freedom of choice, and offsetting the mental anguish that can come from being uprooted from familiar settings. For those needing a higher level of care, Assisted Living Facilities, and Skilled Nursing Facilities are also available through Medicaid benefits.

Potential Medicaid Pitfalls

There are some important things to consider before applying for Medicaid for long term care. There is a look back period in which Medicaid will not only verify current assets, but all assets over the last 5 years. Simply put, it is not considered acceptable for considerable assets to disappear without coming under intense scrutiny. An experienced elder-law attorney can be utilized to assist families and individuals in setting up trusts and legitimately spending down their assets in order to meet eligibility requirements. Medicaid also has an estate recovery clause that mandates for individuals age 55 or older, states are required to seek recovery of payments from the individual’s estate for nursing facility services, and those enrolled in a Home and Community Based Services Waiver Program. A Medicaid recipient’s assets from his/her home will not be recovered while a spouse is living there. In addition setting up a survivorship deed for a spouse can exclude a home from being recovered even after the surviving spouse has passed.

Medicaid is a viable option for long term care. In many situations, the same level of quality care being provided to persons paying privately, or utilizing long-term care policies is available through Medicaid as well. Many in home senior care agencies, including many of your local Vida Certified Home Agencies accept Medicaid. In addition, thanks to more stringent regulation, the level of quality care at the Nursing Home level has increased across the board. If you are considering Medicaid as an option for long term care, please do your own due diligence, consider the benefits and drawbacks, speak to your local Department of Human Services, and consider all available options.

If you would like more information about Medicaid or need help with a loved one or friend you can always call us at 1-866-273-2995, visit our Senior Home Care Agency Directory, or fill out this simple online form. Get Help Now!