NEW YORK (PRWEB)
June 30, 2022
Medicaid is jointly funded by the federal government and states, which provides healthcare coverage to millions of low-income Americans for acute and long-term services and supports (LTSS) needs. In 2020 alone, Medicaid paid $200.1 billion for LTSS which is 42.1% of the total LTSS spending (475.1B). And about 60% of the national nursing home expenditure was covered by Medicaid. Among the LTSS beneficiaries under this coverage, more than 50% were older adults aged 65 and above.
Medicaid Types
Medicaid programs for long-term care can be categorized into three types:
Institutional Medicaid: Covers Hospital services, Skilled Nursing Facilities (SNFs), nursing homes, Intermediate Care Facilities for People with Intellectual Disabilities (ICF/ID), and Services for Individuals 65 and older in a mental health facility.
Medicaid Waivers: State-specific waiver program called Medicaid Home and Community Based Services (HCBS) pays for long-term care services outside the nursing institutions (like assisted Living facilities) that traditional Medicaid does not cover.
Cash and Counselling: Provides cash allowances and allows beneficiaries to choose their caregivers, including spouses or family members.
Medicaid LTSS Benefits
LTSS refers to medical and non-medical personal care for an extended period of time-maybe several weeks or even years. It includes activities of daily living (like eating, bathing, etc.) and instrumental activities of daily living (like transportation, medication management, etc.) for people with care needs.
Almost 6 million older adults are under Medicaid coverage in the United States as of November 2021. Due to the high cost of senior living facilities like assisted living and nursing homes (ranging from $51,600 to $93,075 annually), many seniors rely on government programs like Medicaid. The mandatory Medicaid benefits include, but are not limited to, hospital care, nursing home care, home health services, doctor’s visits, transportation to medical facilities, and Mental health and personal care aides.
Below are long-term care services that Medicaid covers:
Long-term nursing home care services are provided in certified facilities- including custodial care for all eligible people aged 21 and above.
Approved long-term care services provided at home, including nurses’ visits and personal care services.
Long-term home and community-based services are provided outside Medicaid-approved institutional facilities (like assisted living, memory care, etc.). For example, personal care, laundry and cleaning services, case management, etc.
Medicaid Eligibility Criteria
Different eligibility requirements apply to different states, Medicaid programs or waivers, and age groups. However, all states will cover nursing homes and other institutional communities’ costs for residents who meet state-specific medical and financial eligibility requirements. But people who are not eligible under regular Medicaid can get waiver benefits for long-term care. In general, the criteria are
Must require nursing home level care
Monthly income can be up to 300% of the Federal Benefit Rate (FBR)
The countable asset does not exceed the limit of $2000 for a single applicant and $3000 for couples.
If only one partner is applying, the asset limit for the non-applicant would be $137,4000
Medicaid Application Process
To apply for Medicaid, seniors can visit the local office of their state, and fill out an application. Alternatively, they can apply online through the Health Insurance Marketplace. The entire procedure goes like this:
BoomersHub suggests that older adults hire a Medicaid planner to make the process easier. These planners can simplify the Medicaid process, provide tips on saving money, and prevent any Medicaid penalties. However, accreditation is needed if you want an advisor to represent you when you file a claim.
To access the complete Medicaid Guide created by BoomersHub, visit https://www.boomershub.com/blog/a-beginners-guide-to-Medicaid/#Institutional_Medicaid.
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