You may need to
learn about your state's Medicaid program even though your parent or
loved one seems to have adequate to resources for the foreseeable
future. The Medicaid program is a government health insurance program
for low income people. Although it may seem that a person has
adequate financial resources to last for quite awhile, long-term care
is very expensive, and some people, who don't expect to ever need it,
may end up having their nursing home care and other medical services
paid for under the Medicaid program.
You may need to
learn the rules of the Medicaid program, or better yet, confer with a
Medicaid lawyer so your parent or loved one doesn't have to use every
available resource needlessly. In fact, they may actually qualify for
Medicaid sooner than they even think they will.
By reviewing these
concerns early on with a Medicaid lawyer, your parent may be able to
protect some of their assets before becoming eligible for the Medicaid
program. When an individual uses up their money prior to becoming
eligible for Medicaid, it is referred to as a "spend down".
Unlike Medicare
which is fully regulated by the federal government, the Medicaid
program is a joint program cosponsored by both the state and the
federal governments. Guidelines are set by the federal government,
and then states set up their own rules and programs within these broad
guidelines. The result is that individual states have various rules
and programs that are relatively specific to those states.
Many states have
special programs that are specially set up for assisting the elderly
that allow them to meet less stringent financial rules if they are in
need of long-term care.
Many elderly
people who qualify under the Medicaid program are referred to as "dual
eligible" meaning that they are eligible to receive both Medicare
(because of their age) and Medicaid (because of their finances). Any
benefits covered under Medicare are usually paid under that program
first prior to being paid for under Medicaid.
The Medicaid
program covers the bulk of a person's health care costs including
nursing home care as well as some "skilled" care services at home,
although sometimes there may be coinsurance amounts to be paid also.
Many doctors and some nursing homes won't accept patients on Medicaid
because the reimbursement for services is relatively low. As a
result, Medicaid patients sometimes get health care at clinics where
they have to wait for a significant period of time and receive
relatively mediocre care. Or, because it may be difficult to get in
one of the better nursing homes, they may have to settle for
substandard care in a nursing home of lesser quality.
Despite these
limitations, the Medicaid program is an incredibly important program
and is a vital and welcome financial safety net. You may want to get
your parent to talk with the state Medicaid counselor or meet with a
Medicaid lawyer who specializes in financial planning for individuals
anticipating meeting the eligibility requirements under the Medicaid
program because the rules are frequently complicated. However, you
should not expect state counselors to advise you or your loved one on
how to protect their assets prior to meeting the eligibility under
your state's Medicaid program.
Medicaid program
overview: