Paying for nursing home care with Medicaid

Dear Savvy Senior,

If my mother needs to move into a nursing home, what are nan eligibility requirements to get Medicaid coverage?

Caretaking Son

Dear Caretaking,

The rules and requirements for Medicaid eligibility for nursing location attraction are analyzable and will alteration according to nan authorities your mother lives in. With that said, here’s a general, simplified rundown of what it takes to qualify.

Medicaid Eligibility

Medicaid, nan associated national and authorities programme that covers wellness attraction for nan poor, is besides nan largest azygous payer of America’s nursing location bills for seniors who don’t person nan resources to salary for their ain care. (Note that immoderate states person different names for their Medicaid program.)

Most group who participate nursing homes don’t suffice for Medicaid astatine first but salary for attraction either done semipermanent attraction security aliases out-of-pocket until they deplete their savings and go eligible for Medicaid.

To suffice for Medicaid, your mother’s income and assets will request to beryllium nether a definite level that’s wished by your state. Most states (except California) require that a azygous personification person nary much than astir $2,000 successful countable assets ($3,000 for a joined couple) that includes cash, savings, investments aliases different financial resources that tin beryllium turned into cash.

Assets that aren’t counted for eligibility see your mother’s location if it’s weighted nether $713,000 (this limit is higher – up to $1,071,000 – successful immoderate states), her individual possessions and family goods, 1 vehicle, prepaid ceremonial plans and a mini magnitude of life insurance.

But beryllium alert that while her location is not considered a countable plus to find eligibility, if she can’t return home, Medicaid tin spell aft nan proceeds of her location to thief reimburse her nursing location costs, unless a spouse aliases different limited comparative lives there. (There are immoderate different exceptions to this rule.)

After qualifying, each sources of your mother’s income specified arsenic Social Security and pension checks must beryllium turned complete to Medicaid to salary for her care, isolated from for a mini individual needs allowance – usually betwixt $30 and $160.

You besides request to beryllium alert that your mother can’t springiness distant her assets to suffice for Medicaid faster. Medicaid officials will look astatine their financial records going backmost 5 years (except successful California which has a 30-month look-back rule) to guidelines retired suspicious plus transfers. If they find one, her Medicaid sum will beryllium delayed a definite magnitude of time, according to a look that divides nan transportation magnitude by nan mean monthly costs of nursing location attraction successful their state.

So, for example, if your mom lives successful a authorities wherever nan mean monthly nursing location costs is $8,000 and she gave distant rate aliases different assets worthy $160,000, she would beryllium ineligible for benefits for 20 months ($160,000 divided by $8,000 = 20).

Spousal Protection

Medicaid besides has typical rules (known arsenic nan organization spouse assets allowance) for joined couples erstwhile 1 spouse enters a nursing home, and nan different spouse remains astatine home. In these cases, nan patient spouse tin support 1 half of nan couple’s assets up to $154,140 (this magnitude varies by state), nan family home, each nan furnishings and family equipment and 1 automobile. The patient spouse is besides entitled to support a information of nan couple’s monthly income – betwixt $2,465 and $3,854. Any income supra that goes toward nan costs of nan nursing location recipient’s care.

What astir Medicare?

Medicare, nan national wellness security programme for seniors 65 and older, and immoderate younger group pinch disabilities, does not salary for semipermanent care. It only helps salary up to 100 days of rehabilitative nursing location care, which must hap aft a three-day infirmary stay.

For much information, interaction your authorities Medicaid office. You tin besides get thief from your State Health Insurance Assistance Program (see ShipHelp.org), which provides free counseling connected Medicare and Medicaid issues.

Send your elder questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, aliases sojourn SavvySenior.org. Jim Miller is simply a contributor to nan NBC Today show and writer of “The Savvy Senior” book.