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Horizon Elder Law & Estate Planning Blog

Thursday, September 12, 2019

Will Medicaid Cover My Nursing Home Expenses?

Nursing homes can be expensive, causing a lot of people to forgo the expense. What many people do not know is that there could be another option: Medicaid. While some people may think that Medicaid is only for “poor people,” that is not the case. Medicaid may provide you with the coverage that you need to afford nursing home. 

Requirements Must Be Met

Many people who apply for Medicaid in order to cover their nursing home expenses are often denied. However, many people take the denial as a loss and move on, when they may be able to successfully appeal the decision. This often occurs due to the complexity of Medicaid eligibility; it is often difficult to understand. 

Though each state has its own Medicaid program with different eligibility requirements, there are four requirements that generally must be met for someone to receive Medicaid coverage for a nursing home (which must be certified by Medicaid and accept Medicaid payment.) These requirements include:

  1. Categorical Requirements – The individual must be at least 65 years of age, blind, or disabled.
  2. Medical Necessity – The individual must have a medical need for staying in a nursing home. Disability or medical need can be proven there are certain documents that must be looked at and are required.
  3. Income Eligibility – The applicant must make no more than $2,199 per month. It is possible to handle pensions and retirement income in a way that does not prevent eligibility regarding income.
  4. Asset Eligibility – Individuals may have no more than $2,000 in assets, while couples entering nursing homes may have no more than $3,000. There are some exceptions including the family home. Additionally, the manner in which an individual owns his or her assets can have an impact on whether they are included in the tally. 

What can I do if I’m interested in Medicaid coverage?

Medicaid will cover the full amount for room and board as well as any therapies that are a part of the nursing home’s general resident care. The coverage also applies to personal care items and specific services including laundry, bathing, and grooming.

Since Medicaid can be very confusing, if you are interested in coverage for a nursing home residency for your elderly parents or relatives, or yourself, it is in your best interest to speak with a knowledgeable and experienced California elder law attorney.

Horizon Elder Law & Estate Planning, Inc. Helps Those in California Who Are Interested in Obtaining Medicaid

We understand the confusion often associated with obtaining Medicaid coverage and we work to help our clients get the coverage that they deserve and are entitled to. 

At Horizon Elder Law & Estate Planning, Inc., we recognize the difference that Medicaid coverage can make on your life. If you have not yet applied or have applied and been rejected, we are here to help you and will fight for what you deserve. To learn more about your eligibility and options regarding Medicaid, or to schedule a consultation, contact us today!

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