Medicaid might help to pay for nursing home care if you have a low income and limited assets. States have different eligibility rules and benefits. Most will pay for personal care and medical services for people who live with an illness or disability no matter their ages. The staff at Elder Care Direction can help you to understand the Medicaid eligibility rules and whether you might qualify so that your nursing home care might be covered.
State-paid Medicaid services
Federal law requires states to pay for certain service to Medicaid recipients who live in nursing homes. States are also required to pay for home health services for people who qualify to receive it at home, including medication management, housekeeping, and home health aides.
Nursing homes are not required to accept Medicaid. You can learn whether a nursing home that you are considering accepts Medicaid by asking. If it does, it has to be state-licensed and to submit to regular inspections.
There are guidelines for eligibility requirements in each state, including income and resource limits. You can qualify for Medicaid to pay for nursing home care if you make up to 300 percent of the income limit set by Supplemental Security Income in states that use the SSI guidelines. In those states, one person can have up to $2,000 of countable assets, and a married couple can have up to $3,000 if both spouses are receiving care.
Assets that are not counted
States can’t place liens against your home if you might return home after your nursing home stay or if you have dependents or a spouse who is living there. Your home can’t be sold to recover benefits if you qualify for Medicaid. After you pass away, the state might be able to recover benefits that it paid for your care from your estate.
If you have assets that are above the Medicaid limit, you must spend down your assets until you are below the limit. You might start your stay in the nursing home as someone who pays privately. Once your assets are spent down, you can then apply for Medicaid.
If you need to reduce your assets to qualify for Medicaid, you need to be aware of the transfer rules. You are not allowed to give away your assets or to sell them for less than what they are worth. Certain assets do not count towards the Medicaid limit, including your home, one car, your household goods, your personal effects, your prepaid funeral arrangement, and a limited amount of cash.
There are some legal ways to reduce your assets, including the following:
- Paying off debts
- Buying a new home
- Prepaying your burial expenses
- Buying an annuity so that your spouse can have a guaranteed fixed amount of income
- Improvements to a noncountable asset
- Vehicle repairs
Medicaid looks back five years from the date of your application to see if you have transferred assets in violation of the rules. If you have, you will face a penalty before you can become eligible for Medicaid.
Estate recovery and spousal protection
If you live in a nursing home and are permanently institutionalized, Medicaid may make a claim against your estate once you die for what it spent to pay for your care. However, the state will not make a claim from your estate until after your spouse passes away and if you do not have any disabled or minor children. Spouses who live in the community are protected under federal law from becoming impoverished because of their spouses’ nursing home care.
Contact Elder Care Direction
The Medicaid rules can be confusing. If you believe that you might need nursing home care in the future, it might make sense to get help with Medicaid planning so that your care might be paid for by the state. To learn more, contact Elder Care Direction by filling out our online contact form.