Medicaid and Medicaid EligibilityWhat is Medicaid ? Medicaid is a medical assitance program jointly financed by state and federal governments for low income individuals. Today, Medicaid is a major social welfare program and is administered by the Centers for Medicare and Medicaid Services (http://www.cms.hhs.gov/), formerly known as the Health Care Financing Administration. Among the services that Medicaid covers are: in-patient hospital services, out-patient hospital services, laboratory and x-ray services, skilled nursing home services, physicians' services, physical therapy, hospice care, and rehabilitative services. Patients are restricted when selecting who will take care of their needs by selecting from pre-approved physicians and other providers of medical care.
Applying for Medicaid and Medicaid Application There is a wrong way and a right way to get on Medicaid. Since the government foots the bill for the health care of the individual who enrolls in the program, after he or she dies, the government will seek restiution. The government can and will take any assets that the individual owned. It becomes property of the US Government. Many seniors or their family try to qualify their loved ones for Medicaid without seeking guidance. Unfortunately, when families try qualify themselves, procrastinate getting the right help or receive the wrong advice, it can be a painful error. Caution for those who try to qualify themselves for Medicaid: You will be penalized and possibly fail to qualify for Medicaid or you will have to deal with estate recovery (when the state comes and takes your hard earned assets). Medicaid Law Medicaid is the U.S Health Insurance program for individuals and families with low incomes and resources. It is jointly funded by the states and federal government, and is managed by the states. Among the groups of people served by Medicaid are eligible low-income parents, children, seniors, and people with disabilities. Medicaid is the largest source of funding for medical and health-related services for people with limited income. Florida Medicaid, Texas Medicaid and Georgia Medicaid (for example) have very subtle difference, just like any Medicaid program for any state. Each state may change it’s law on Medicaid eligiblity ever so slightly. Comparisons with Medicare Although their names are similar, Medicaid and Medicare are very different programs. Medicare is an entitlement program funded entirely at the federal level, while Medicaid is a social welfare program with both state and federal funding. One criterion for Medicaid eligiblity is being impoverished under the program's guidelines — this plays no consideration in determining Medicare coverage. While Medicaid and Medicare cover similar groups, there are important differences between them. For example, Medicaid covers a wider range of health care services than Medicare, and Medicaid does not have premiums, deductibles, and co-pays like Medicare. You can be enrolld for Medicare and Medicaid at the same time.
Medicaid EligibilityMedicaid is a joint federal-state program that provides health insurance coverage to low-income children, seniors and people with disabilities. While Congress and the Centers for Medicare and Medicaid Services set out the main rules under which Medicaid operates, each state runs its own program. As a result, the eligibility rules are somewhat different in every state, although the framework is the same throughout the country. Both the federal government and most state governments have made many changes to the eligibility requirements and restrictions over the years. This has most recently occurred with the passage of the Deficit Reduction Act (DRA) of 2005 (Pub.L. No. 109-171) which significantly changed rules governing the treatment of asset transfers and homes of nursing home residents. The implementation of these changes will proceed state-by-state over the next few years. To be certain of your rights under the Act you should consult an expert, as the rules are complex. The DRA now requires that anyone seeking Medicaid must produce documents to prove that they are a United States citizen or resident alien. |
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Strategies on Paying for Nursing Home Care and Medicaid The decision to place your loved one into a nursing home is an extremely difficult decision, often causing much guilt for the caregiver. It is a very emotional decision for most clients we see and most are under a certain amount of stress, often great, when facing what they consider to be a drastic course of action.I counsel our caregiver clients to get beyond the guilt as quickly as they can, because the situation their loved one is in is not the caregiver’s fault. And besides, the longer you remain under this stress, the less healthy you eat, or you eat way too much, the less you sleep, and some start drinking (my own mother started this late at night after she got my dad settled in bed for the evening – not healthy to say the least). The stress of caring for a loved one is constant and unrelenting. It is a physical, mental and emotional grind. On numerous occasions, we have actually had caregiver clients die before the spouse in the nursing home. Sometimes, the caregivers die shortly after the nursing home spouse dies. The stress of being a caregiver can be deadly serious, especially for older clients who are caregivers for their spouse. You have to recognize it and develop a plan to deal with it. Get your children involved in developing a plan to deal with your loved one’s incapacity. And remember, plan for the absolute worst case scenario. Get to an attorney who can help you develop a plan to help you with your particular situation. And this is especially important as soon as you detect any signs of dementia in your parent or spouse, or as soon as you begin to detect physical problems with your loved one. The sooner you begin the plan, the better off the family will be. NOW, HOW DO WE PAY FOR MAMA’S NURSING HOME CARE? There are really only three ways to pay for a stay in a nursing home. LONG TERM CARE INSURANCE (LTCI). If Mama was far-sighted enough, she may have purchased LTCI in the past before she needed it. This would be an excellent source of funds to help defray some or all of Mama’s long term care costs. Unfortunately, very few seniors, those over age 60, have LTCI coverage. SELF PAY. This essentially means that Mama has enough income or financial assets to pay her own way in the nursing home. However, many families don’t have the income or the financial asset base to be able to pay $4,000 to $7,500 or more a month for a bed for very long in a nursing home. MEDICAID. This is a state-administered medical benefit program which will pay for the cost of a nursing home stay if three tests are met, i.e., medical need, asset, and income. Medicaid is obviously a needs-based program, funded partially by state funds, but mostly by federal funds. Many people are under the mistaken impression that MEDICARE, which most seniors in this country over age sixty-five participate in to one degree or another, will cover the cost of their stay in a nursing home. Link Partners Retire in South Carolina and get free South Carolina retirement information on South Carolina Elder Law topics, South Carolina Estate Planning and South Carolina real estate information. The Marketing Rebel- Best Damn Marketing Advice On This Planet! SEO, Direct Mail, Internet Marketing, Direct Response, Marketing, Copywriting. Get treatment alternatives and advice on cancer. Find out how to treat Breast Cancer, Prostate Cancer, Skin Cancer and how you can beat it! http://www.CarolinaBabyBoomer.Com South Carolina Senior Services, Information, South Carolina Nursing Homes, South Carolina Retirement, South Carolina Estate Planning Attorneys and more! www.SouthCarolinaNursingHome.Org - South Carolina Nursing Home Information, South Carolina Care Assessments and Skilled Care. |
