Many seniors cannot afford to pay $7,500 to $11,000 per month or more for the cost of a nursing home, and those who can pay for a while may find their life savings wiped out in a matter of months, rather than years.[/box]
Contact a Medicaid attorney if you are doing Medicaid planning in the event you need to go to a nursing home. This is a very complicated area of law and you need quality legal assistance to ensure that you take full advantage of the law without doing anything illegal.
Medicaid is health insurance that helps many people who can’t afford medical care pay for some or all of their medical bills. Medicaid is available only to people with limited income. You must meet certain requirements in order to be eligible for Medicaid.
You must qualify for Medicaid. Low-income is only one test for Medicaid eligibility; assets and resources are also tested against established thresholds. As noted earlier, categorically needy persons who are eligible for Medicaid may or may not also receive cash assistance from the Temporary Assistance for Needy Families (TANF) program or from the Supplemental Security Income (SSI) program. Medically needy persons who would be categorically eligible except for income or assets may become eligible for Medicaid solely because of excessive medical expenses.
The State Medicaid program pays for hospital, doctor, prescriptions, nursing home and other healthcare needs.
The pile of paperwork required and an often inefficient government processing system can make filing an application for public benefits an enormous project. Although the federal government shares the cost of funding the Medicaid program with the states and requires the state government to uphold certain standards with respect to efficiency and the granting of Medicaid applications, it is not uncommon for a state or county office to fail to meet the federally imposed guidelines.
According to a study published by the New England Journal of Medicine almost half of all Americans will spend some time in a nursing home. The average cost of a nursing home in the United State is approximately $9,000 per month, and in some areas it exceeds $10,000 per month.
There are five ways to pay for a nursing home: private pay, long-term care insurance, Medicare, Veterans benefits, and Medicaid. Only about 5% of Americans have long-term care insurance. Many are uninsurable or cannot afford such insurance. At most, Medicare pays part of 100 days. Less than 1% of nursing home residents are receiving Veterans benefits.
The major alternative to private pay is, therefore, Medicaid. By carefully designing a thorough Medicaid plan, security can be ensured for the Community Spouse and a legacy can be preserved for children. Failure to design a sophisticated plan may result in the Community Spouse being unable to maintain his or her standard of living. In some instances, the family home may have to be abandoned. The rules of eligibility for Medicaid are strict.
Medicare and Medicaid are two different programs. Medicaid is a state-run program providing hospital and medical coverage for low-income residents, and each state has its own eligibility rules and coverage benefits. Some people qualify for both programs. Information about the Medicaid program is available from local medical assistance agencies, social services or welfare offices.
Medicaid is health insurance available to certain people and families who have limited income and resources. The rules for counting your income and resources (like bank accounts or other items that can be sold for cash) usually depend on which state you live in. Eligibility may also depend on how old you are and whether you are pregnant, whether you are blind or have other disabilities, and whether you are a U.S. citizen or a lawfully admitted immigrant.
If a woman’s labor and delivery of her child is covered by Medicaid, her baby may be covered for up to 1 year without needing to apply. Even if you aren’t sure whether you qualify, if your income is limited, and if you or someone in your family needs health care, you should apply for Medicaid and have a qualified caseworker in your state look at your situation.
People with Medicaid may also get coverage for services such as nursing home care. Depending on your state’s rules, you may also be asked to pay a small part of the cost (copayment) for some medical services. If you qualify for both Medicare and Medicaid, most of your health care costs will be covered.
Medicaid Coverage may start retroactive to any or all of the 3 months prior to application, if the individual would have been eligible during the retroactive period. Coverage generally stops at the end of the month in which a person’s circumstances change. Most States have additional “State-only” programs to provide medical assistance for specified poor persons who do not qualify for the Medicaid program. No Federal funds are provided for State-only programs.
Application for Medicaid | Medicaid Applications | Medicaid gov
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Applications for Medicaid. How to apply for Medicaid in your State.