What Does Medicaid Cover?
If you are age 65 or older and eligible for Supplemental Security Income
(SSI) and/or Old Age Pension (OAP) state supplemental payments, you will
be eligible for Medicaid. Medicaid covers some of the same kinds of services
as Medicare and also covers a number of medical services Medicare does
not. It covers most long-term care, including long-term skilled nursing
care, and nonmedical personal care such as adult day care and at-home
assistance with the activities of daily living.
Additionally, if you are found to be eligible, Medicaid may cover some
of these bills retroactively. Retroactive eligibility can go back to the
beginning of the third month before the date you filed your application.
In order to be covered by Medicaid, the client must make sure that the
care was prescribed by a doctor, administered by a provider who participates
in Medicaid, and determined to be medically necessary.
The Medicaid Application Process
Applying for Medicaid will involve several steps. First, you will have
to complete a written application with the County Department of Human
Along with the application, you will need to provide the Medicaid office with:
- Documentation to verify your income
- Identification and your family's resources such as pay stubs, income
tax returns, Social Security benefits information
- Papers showing all your savings and other financial assets
- Automobile registration papers if you own a car
- Your Social Security card or number
- Information about your spouse's income and separate assets
You will receive a decision on your Medicaid application after the County
Department of Human Services/Social Services reviews the completed application
and your medical necessity has been confirmed with a visit.
Medicaid Rules that Must Be Followed
If a spouse remains at home, Medicaid allows that community spouse additional
assets and income to support the community spouse. In addition, Medicaid
allows the applicant to have a home ( up to $500,00 equity) so long as
the applicant intends to return home or a spouse, minor child remains
in that home. In addition, the applicant and spouse may own irrevocable
prepaid burial plans.
Medicaid has strict rules regarding gifting within five years of the application.
In addition, Medicaid has strict rules regarding any annuity or life estate
owned by either the applicant or the spouse. Our Longmont elder law lawyers
at Jorgensen, Brownell & Pepin, P.C. can assist with the understanding
and application of these various rules.
For Planning Assistance, Contact Jorgensen, Brownell & Pepin, P.C.
Planning now can protect your assets in the future and insure your care.
Our elder law attorneys will explain options for
protecting a loved one's assets, qualifications for medical care programs and ways to fund nursing home
care. When necessary, we consult tax experts, accountants and healthcare
planners in order to create a comprehensive plan designed to meet the
unique needs of your loved one.