Many people assume Medicare will pay all of an elderly person’s medical bills. They should learn that this program doesn’t cover long-term care and other expenses. What should a family do when their loved one lacks the funds for quality care as they age?
There are various Medicaid programs designed for the elderly in need of long-term care. Each state determines the names of the programs and eligibility requirements. Furthermore, states offer multiple programs, so an elderly relative might not qualify for one program but could be eligible for another.
What Do Medicaid Programs Cover?
Medicaid programs vary in what they cover. Certain programs are designed for a particular type of care, while others may cover several types. People often ask about what Medicaid benefits a loved one may receive based on where they are receiving care.
Individuals in nursing homes may have all their living expenses paid by Medicaid, but they must have very few financial assets to qualify. Furthermore, they must need this higher level of care.
Men and women in assisted living communities may receive help paying for their living arrangements. Medicaid doesn’t pay room and board for these men and women but may cover other expenses. Waivers oversee these payments, and they have long waiting lists, so a family should not count on them.
Seniors who want to age in place may find they need in-home care to achieve this goal. Individuals who medically and financially qualify may have this care paid for by Medicaid. State Plan Medicaid programs guarantee payments for in-home care, but a person might need a waiver to pay for this care, and waivers are limited.
Adult daycare is covered in all states for qualified individuals. Waivers often apply, so families must plan for these expenses and know what is available in their state.
A state’s Medicaid program might also pay for adult foster care. Again, room and board aren’t covered, but other aspects of care may be. Waivers are used for these payments.
Medicaid Eligibility
Families must understand Medicaid eligibility requirements for their loved one’s state. Programs look at a person’s income and assets, whether they are married, and whether both spouses are applying. Eligibility requirements also vary by program, and states may offer multiple pathways to eligibility. Many people find they don’t qualify when they first apply. They might seek help from a third party to learn how to proceed so they can receive help paying for necessary care.
Individuals often need to have a monthly income of $2,200 or less to qualify for Medicaid, and the value of their assets cannot exceed $2,000. However, these figures may change at any time, so a person should always review the requirements before applying. Married couples can have higher income levels and countable assets. When one spouse resides in the home and the other requires long-term care, the state factors in that they have separate living arrangements.
Applicants cannot give away assets to qualify for Medicaid. They must go through a process to become eligible and use these assets to pay for care initially. If assets are to be given away, this must be done well before long-term care is needed, or the individual won’t qualify. Consider talking with a Medicaid planning professional to help navigate the different programs. Their input will be priceless as the process moves forward.
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