Medicaid and Long-Term Care

Previously, we’ve covered Medicare and some of the things that the program covers, but you might still have questions regarding Medicaid, so the focus of this article will be on Medicaid and long-term care. As you may know, Medicaid is a jointly-run program from both federal and state government, and it can help those individuals with low income and assets to be able to pay for some, if not all, of their health care bills. In general, it covers medical care, such as doctor visits and hospital costs, long-term care services in nursing homes, and long-term care services provided at home, like visiting nurses and assistance with personal care. It is important to know, however, that unlike Medicare, Medicaid will pay for custodial care in nursing homes or in one’s own home.

Federal requirements dictate the overall rules for the program, such as who can be eligible for Medicaid and what services are covered, but individual states have a lot of freedom in how they conduct their programs. States are required to cover certain groups of people, but they also have the option to cover more groups as well. Also, states are required to cover certain services too, but they have the option to cover more if they want to do so. Because of this, both eligibility rules and the services covered can and do vary from state to state.

In order to be eligible for Medicaid, you have to meet certain requirements, including having both income and assets that don’t go over the levels used by your state.

Once the state determines that you do indeed qualify to receive Medicaid, they will then make an additional determination of whether or not you qualify for long-term services as well. In doing so, many states use a specific number of personal care or other service needs to qualify for either nursing home care or home and community-based services. There may also be some different eligibility requirements for any different types of nursing home and community-based services.

The State Medical Assistance Office is your best source of information you need about how to qualify for Medicaid in your state, as well as finding out if you qualify for any long-term care services.