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Does Medicaid Cover Nursing Home Care?

Does Medicaid Cover Nursing Home Care?

The ins and outs of applying for Medicaid can be challenging to understand. It seems that the eligibility and paperwork requirements are almost insurmountable. The complexity of the Medicaid system is exactly why we offer our services. With that said, we thought we’d offer some simple answers to a common question; what will Medicaid cover when it comes to nursing home care?

Will Medicaid Pay for a Nursing Home?

There are a lot of caveats to the answer to Medicaid nursing home care eligibility. However, the short answer to the question is yes. Every state in the United States offers Medicaid. If you meet the financial and circumstantial eligibility requirements in your state, Medicaid will pay for your nursing home.

Known as MassHealth, Massachusetts’s Medicaid program has unique requirements, which can change based on your marital status, but, once you’re approved for Medicaid, it will cover the entire cost of your nursing home care for as long as you need it.

Am I Eligible for Nursing Home Medicaid Coverage?

Your eligibility is determined by several factors, one of the most important being your countable assets. Countable assets are typically cash, stocks, investments, bonds, IRAs, savings, and real estate (property that you don’t reside at). The exact asset amount that meets eligibility requirements varies based on state.  In Massachusetts, the countable asset limit is $2,000.

If you’re married, the countable asset limit is a bit more complicated. The spouse in the facility remains at that $2,000 limit, but the spouse in the community can own up to $137,000. Now, if your assets don’t identically meet those markers, you’re not out for the count. Some actions can be taken to get you the coverage you need.

How Much Will Medicaid Pay for Nursing Home Care?

If you are approved for Medicaid nursing home care coverage, then Medicaid will cover 100% of your expenses. Nursing homes make this even easier because they don’t break down individual expenses as line items; they charge at a flat rate, which Medicaid pays.

A common misconception we hear often is that you have to surrender your income for Medicaid to pay for the facility. In reality, you work directly with the facility and money remains in your pocket. Funds for a “personal needs allowance” that can go towards anything extra you might want or need, as well as any medical insurance you may pay for remain with you.

What Percentage of Nursing Homes Accept Medicaid?

The percentage of nursing homes that accept Medicaid is deceptively high, about 80%. However, it’s important to consider that many nursing homes accept Medicaid but offer “Medicaid beds,” which are often shared rooms.

Medicaid is a great service, but many nursing homes prefer private pay residents because they typically pay up to 25% more for their nursing home care. It’s important to find nursing homes that truly respect the Medicaid process and fairly accommodate Medicaid, which leaves you just as comfortable as a private pay resident.

Are you interested in applying for Medicaid? Don’t sweat the paperwork or eligibility requirements. Allow Brunelle Medicaid Consultants to help you navigate the Medicaid process and application assistance to get you the most out of your application.