A Beginner’s Guide to Medicaid

Medicaid is a state-administered federally controlled health insurance program. It covers vulnerable people from birth to age 65 and beyond. The system and its rules, however, can be confusing, especially if you are attempting to navigate it for a loved one or patient.

Since 1965, Medicaid has provided insurance for families, but its importance rose recently due to the rising costs of medical services and medication. Sadly, the most considerable financial toll is on people who need it the most, including children, disabled people, and aging adults. These individuals depend on Medicaid to afford the services and support they need to have a good quality of life. 

Medicaid is an excellent resource for aging adults since it works with Medicare and provides comprehensive coverage. Understanding the nuances of Medicaid like who it covers and who qualifies for coverage, however, can be confusing. Requirements vary from state to state. 

What Does Medicaid Cover?

Here are some of the required coverages of Medicaid: 

• Hospital care 
• Skilled nursing 
• In-home care 
• Doctor’s visits 
• Preventative care 
• Wellness screenings 
• Medical Transportation 
• Diagnostics 

Who Qualifies for Medicaid?

Forty-two states have now adopted the optional Special Income Level standard to qualify for Medicaid. Under the special income rule, people expected to need nursing home care for at least 30 days can earn up to 300% of the Supplemental Security Income Federal Benefit Rate. Many states have set the income level to be $794, which is 100% of the FBR. Other states require individuals to use all of their income for institutionalized long-term care before Medicaid kicks in. Luckily, there are different ways for people who have medical needs to qualify. 

Asset Limits and Exemptions

Medicaid is strict with its asset limits of $2000 per applicant, but they allow for some exemptions. For example, if your spouse needs nursing home care, but you plan on staying at home, you may be entitled to keep a certain amount of assets. 

The following items are considered assets:

• Investments 
• Cash in bank accounts 
• Second vehicles or homes 
• Life insurance policies 
• Revocable trusts 
• Certain Annuities 

These items are considered exempt assets:

• Retirement accounts 
• A primary vehicle 
• A primary home 
• Personal property 
• Household items

The American Council of Aging offers a state-by-state eligibility guide for further information. You can also find additional support at MedicaidPlanningAssistance.org. This website will help find the income limit by state. 

At Next Day Access, we care about aging adults getting the support they need to live their best lives. We offer our support by providing the products they need to help with mobility and accessibility. Nous contacter today to schedule your free in-home complimentary consultation.