What You Should Know About: Understanding Medicaid
Medicaid is a joint federal-state government program designed to provide health-care assistance to low income people with limited assets, and it has become the major payer of services for care in nursing homes across the country. In Pennsylvania, nearly two out of every three nursing home residents is on Medicaid.
Eligibility:
Medicaid will pay for nursing facility care for those individuals 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. 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 Area Agency on Aging office 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 home 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.