Paying for Long Term Care

Medicaid

Medicaid is a joint federal-state government program designed to provide health care assistance to low income people, and it has become the major payer of services for care in a nursing facility. In many states, Medicaid will pay for assisted living services, although in most cases such coverage is limited.

Eligibility

Medicaid will pay for nursing facility care for those persons who meet a state-determined poverty level and certain health related criteria, provided the nursing facility is certified, and meets a stringent set of government standards.

Benefits

Medicaid will pay for care in a nursing facility (NF). The amount paid is determined by each state, and covers room, board, nursing care and social activities.

How to Apply for Medicaid

Contact your local Department of Welfare or Department of Health for an application. Because Medicaid is based on financial need, you will be asked for extensive information such as residence, family composition, income, real and personal property, banking/investment transactions and medical expenses.

Risk of Impoverishment

Spouses of nursing facility residents are protected from what is termed “spousal impoverishment.” This refers to the required depletion of an “at home” spouse’s financial resources so that the spouse in a nursing facility can qualify for Medicaid. States are required to permit the at-home spouse to retain a “maintenance needs allowance” from the other spouse’s income that is sufficient to bring the at-home spouse’s income to 150 percent of the federal poverty level for a two-person household.

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