Use Medicaid to pay for nursing home
Dear Savvy Senior,
What are the eligibility requirements to get Medicaid coverage for nursing home care?
The rules and requirements for Medicaid eligibility for nursing home care are somewhat complicated and will vary according to the state you live in. With that said, here’s a general, simplified rundown of what it takes to qualify, along with some resources you can turn to for help.
Medicaid, the federal and state joint program that covers health care for the poor, is also the largest single payer of America’s nursing home bills for seniors who don’t have the resources to pay for their own care.
Most people who enter nursing homes don’t qualify for Medicaid at first, but pay for care either through long-term care insurance or out-of-pocket until they deplete their savings and become eligible for Medicaid.
To qualify for Medicaid, your income and assets will need to be under a certain level that’s determined by your state. Most states require that a person have no more than about $2,000 in countable assets that includes cash, savings, investments, or other financial resources that can be turned into cash.
Assets that aren’t counted for eligibility include your home if it’s valued under $525,000 (this limit is higher -- up to $786,000 -- in some states), your personal possessions and household goods, one vehicle, prepaid funeral plans, and a small amount of life insurance.
But be aware that while your home is not considered a countable asset to determine your eligibility, if you can’t return to your home, Medicaid can go after the proceeds of your house to help reimburse your nursing home costs, unless your spouse or other dependent relative lives there. (There are some other exceptions to this rule.)
After qualifying, all sources of your income such as Social Security and pension checks must be turned over to Medicaid to pay for your care, except for a small personal needs allowance -- usually between $30 and $90.
You also need to be aware that you can’t give away your assets to qualify for Medicaid faster. Medicaid officials will look at your financial records going back five years to root out suspicious asset transfers. If they find one, your Medicaid coverage will be delayed a certain length of time, according to a formula that divides the transfer amount by the average monthly cost of nursing home care in your state.
So if, for example, you live in a state where the average monthly nursing home cost is $5,000 and you gave away cash or other assets worth $100,000, you would be ineligible for benefits for 20 months ($100,000 divided by $5,000 = 20).
Medicaid also has special rules for married couples when one spouse enters a nursing home and the other spouse remains at home. In these cases, the healthy spouse can keep one half of the couple’s assets up to $113,640 (this amount varies by state), the family home, all the furniture and household goods, and one automobile. The healthy spouse is also entitled to keep a portion of the couple’s monthly income -- between $1,838 and $2,841. Any income above that goes toward the cost of the nursing home recipient’s care.
What about Medicare?
Medicare, the federal health insurance program for seniors 65 and older and some younger people with disabilities, does not pay for long-term care. It only helps pay up to 100 days of “rehabilitative” nursing home care, which must occur after a hospital stay.
Again, Medicaid rules are complicated and vary by state, so contact the local Medicaid office (call 1-800-633-4227 for contact information) for eligibility details.
You can also get help from your State Health Insurance Assistance Program (SHIP), which provides free counseling on all Medicare and Medicaid issues. To find a local SHIP counselor, visit shiptalk.org, or call 1-800-677-1116.
Jim Miller is a contributor to the NBC “Today” show and author of The Savvy Senior book. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org.
Your Opinions and Comments
Be the first to comment on this story!
You must be logged in to post a comment.
South Texas Living Archives
Atascosa County Craft Show is Nov. 12 (October 26, 2016)
Baptist church to offer holiday decorating ideas (October 26, 2016)
Boldtville church plans fair, barbecue (October 26, 2016)
Dobie Dichos kicks off Storyfest (October 26, 2016)
Don’t miss tricks or treats at ‘The Dark Side of F Street’ (October 26, 2016)
DRT plans 125th anniversary celebration (October 26, 2016)
Egg cups (October 26, 2016)
Enjoy Hallelujah Night in Kenedy (October 26, 2016)
Enjoy spooky fun at Haunted Harvest Fest (October 26, 2016)
Enjoy ‘unusual’ Halloween Concert in Boerne (October 26, 2016)
Floresville Opry gets set for monthly schedule (October 26, 2016)
How much does a funeral cost? (October 26, 2016)
Kicaster Cemetery fund-raiser is Oct. 29 (October 26, 2016)
Labatt Club enjoys salad demo at October meeting (October 26, 2016)
Letters from Wilson County, Part I (October 26, 2016)
LV Band Boosters Pancake Breakfast (October 26, 2016)
New book celebrates Spurs Nation (October 26, 2016)
Plan for St. Mark Fall Festival (October 26, 2016)
See ‘A Brush With Color’ (October 26, 2016)
Show Barn Country Dance (October 26, 2016)
Three Oaks Senior Dinner is Nov. 2 (October 26, 2016)
Tips to get your teen to eat more fruits and vegetables (October 26, 2016)
Turkey Dinner Nov. 6 at St. Jerome (October 26, 2016)
Ways to support the bereaved at holiday time (October 26, 2016)
What every Spurs fan should know (October 26, 2016)
Zumba for a cause Oct. 29 (October 26, 2016)
A creepy Halloween party appetizer (October 19, 2016)
Applying for Social Security (October 19, 2016)
Chili Cook-off to benefit Wilson County youth (October 19, 2016)
DRT joins Heritage Music Festival (October 19, 2016)
DRT to meet Oct. 24 in Kerrville (October 19, 2016)
Enjoy Harvest Festival in Marion (October 19, 2016)
Enter Pecan Bake Show (October 19, 2016)
Little Golden Books (October 19, 2016)
Make plans for Halloween fun and fall fests (October 19, 2016)
Meeting the needs of the community: St. Vincent de Paul (October 19, 2016)
R&B legend opens Carver season Oct. 29 (October 19, 2016)
Readers share their spooky tales, part two (October 19, 2016)
Road Runners plan Oct. 22 group run (October 19, 2016)
See country legends Oct. 22 (October 19, 2016)
Try your hand at square dancing (October 19, 2016)
Turn yard waste into gardener’s gold (October 19, 2016)
Baptist church to ring in 100 years (October 12, 2016)
Church plans Junk and Treasure Sale (October 12, 2016)
Comal Country Music Show is Oct. 18 (October 12, 2016)
Davy Crockett (October 12, 2016)
Enjoy fried chicken in Poth Oct. 23 (October 12, 2016)
Enjoy this flashy winter resident (October 12, 2016)
Join in the 2016 Rosary Crusade (October 12, 2016)
National Charity League plans celebration (October 12, 2016)
New program increases student knowledge of E-cigarette dangers (October 12, 2016)
Play bunco in La Vernia Oct. 22 (October 12, 2016)
Pondering a poignant letter from the past (October 12, 2016)
Save the date for Oct. 22 March for Life (October 12, 2016)
Should you redeem old savings bonds? (October 12, 2016)
Show Barn Cook-off approaching (October 12, 2016)
Sutherland Springs Old Town Day (October 12, 2016)
The business of aging grows more complex (October 12, 2016)
Try your luck at China Grove Lions Club Casino Night (October 12, 2016)
Atascosa County Craft Show seeks vendors (October 5, 2016)
Beautify your landscape with cacti (October 5, 2016)
Experience Oktoberfest in San Antonio (October 5, 2016)
Gilded peanuts and golden memories — recalling past Floresville Peanut Festivals (October 5, 2016)
Japan Fest set for Oct. 16 (October 5, 2016)
Meal service delivery options for seniors who don’t cook (October 5, 2016)
Oktoberfest comes to Floresville Oct. 15 (October 5, 2016)
Past Pirate champions will never be forgotten (October 5, 2016)
Readers share their ‘spooky’ tales (October 5, 2016)
Sacred Springs PowWow (October 5, 2016)
Shorter teapot (October 5, 2016)
Sinatra tribute comes to Kerrville (October 5, 2016)
Stockdale librarian updates Blue Bonnet Club members (October 5, 2016)
Sunnyside 4-H Bake Sale (October 5, 2016)
Time for turkey in Cestohowa (October 5, 2016)