Archive for January, 2011

Medicaid Myths in Long Term Care

Monday, January 17th, 2011

You may have heard a friend, family member or neighbor tell a story about an elderly relative that had “all their money taken by a nursing home” or “the state took all their money when they went into the nursing home”.  This is another one of those myths regarding coverage of long term care, like the one we covered in the last blog about Medicare.

Unlike Medicare, Medicaid does cover long term care, but you have to qualify. Medicaid both in the community and in a nursing facility is a program for low-income individuals who must qualify by meeting the income guidelines. When it comes to paying for nursing home care, you have to meet the medical criteria showing that you need the physical assistance, as well as, showing that you have no more than $4,000 is assets and no more than $2,000 in monthly income.

When someone states “the nursing home took all of my mother’s money”, most likely the Medicaid guidelines were not properly explained to them or it was oversimplified by the person explaining it. Often when someone is admitted to a nursing home for long term care, the nursing home must look at their financial records to see how they will pay for the care, they will counsel the person and /or their family on how much care at the facility costs and should help them determine if and when they will need to apply for Medicaid. When a person has enough money to pay, but knows they may run out in six months to a year, they call this a “spend down period” which means you pay the nursing home the monthly rate and when you’ve “spent down” your funds to the Medicaid eligibility level, you can apply for Medicaid.

There may be people who are under the false impression that Medicaid or some other program, will automatically cover you when you need nursing home care, similar to the false belief that Medicare covers long term care costs. We pay for goods and services all the time, but when it comes to long term care there is much confusion and false assumptions.