Consider This Scenario
Ernie and Alice, both in their early 80s, have been married for over 60 years. Ernie was recently diagnosed with Alzheimer’s disease and his condition is worsening. As Ernie’s primary caregiver, Alice is feeling overwhelmed navigating their financial situation, especially concerning Ernie’s long-term care needs and how to pay for his care.
While their children, who live in different states, offer as much assistance as possible, they too are uncertain about Medicaid, including its eligibility criteria and coverage. During one of their visits, they decide to investigate.
LivWell Seniors understands many people are unsure of what Medicaid is and who qualifies to receive it. After reading this short, yet informative article by the Alzheimer’s Association, Ernie, Alice, and their children feel a bit more confident about what Medicaid is and who it is for. If you are interested in learning more about Medicaid, this is a great place to start.
Medicaid pays for medical care for people with very low income and asset levels, and long-term care for people who have used up most of their own money. It is a program jointly funded by federal and state governments.
Medicaid is a federal/state program typically administered by each state’s welfare agency.
Eligibility: Eligibility and benefits vary from state to state. If the person living with dementia is eligible for Supplemental Security Income (SSI), he or she may also be eligible for Medicaid depending upon the individual’s state law. Those not on SSI must have limited income and assets. The amount is determined by each state.
When determining income and asset levels for individuals who live in a nursing home (which Medicaid refers to as nursing facilities) or receiving home- and community-based services, there are also specific guidelines to protect spouses who live in the community from impoverishment.
Special considerations: The person with dementia should be very careful about giving away assets to family members to qualify for Medicaid. Strict laws govern this area. Check with your legal adviser to be sure you are fully aware of the legal and financial results of transferring property and money.
Medicaid and long-term care: Most states have home- and community-care options for people who qualify, which allow individuals to live in their homes in the community and receive long-term care services. Most people with Alzheimer’s disease or other dementias will eventually need long-term care services and many will require nursing home care. For people who meet eligibility requirements, Medicaid covers all or a portion of nursing home costs. Be aware that not all nursing homes accept Medicaid.
How to apply for Medicaid: For an application, contact your local Department of Welfare or Department of Health. Medicaid is based on financial need. So, you will be asked to supply information, including:
- Where you live
- Family members
- Your monthly income
- Medical expenses
Most nursing homes that accept Medicaid will have staff who can assist you in applying.
Visit Medicaid’s website (medicaid.gov) for more information.