What is Medicaid?
Medicaid is a joint federal and state program that helps with medical costs for some people with limited income and resources. In order to have Medicaid pay for a nursing home, medical necessity must also be shown. Once a person receives benefits, they pay the portion deemed appropriate by the government and Medicaid will make up the difference for the cost of care. Medicaid is the entity that pays for the care given in the nursing home and room and board. Keep in mind that Medicaid does not pay for your doctor or medicines, Medicare does that.
How do I get Medicaid? Do I need a lawyer?
St. Francis social service department is available to help with completing the necessary paperwork and filing the application with the Medicaid office. Lawyers can and should be used for those individuals/couples who have extenuating circumstances. If you receive more than the income limit you will need to set up a Qualified Income Trust. The social service department will let you know if you need a lawyer to execute your application.
I already have Medicaid, I get help at home.
There are different qualifications for Nursing Home Medicaid. Even if you get Medicaid at home you will need to reapply through the system showing financial need for nursing home residents, this is a different criteria. The nursing home will provide the necessary information for Medicaid to evaluate the medical need. You will qualify for benefits if you are able to prove both financial and medical necessity.
I can’t get Medicaid, I get too much money.
Not necessarily. If you make above the qualifying limit you can still receive benefits. This will require a special account to be set up by a lawyer. Social services will let you know if this type of situation applies to you.