Medicaid Nursing Home Eligibility

Presently families of nursing home applicants are faced with a financial challenge or burden depending how they approach the issue.
Most nursing home residents are discharged from hospitals and are admitted for some rehabilitation, such as, occupational therapy or physical therapy or both. Some insurances (Medicare, Medicare Advantage, Long Term Care, and/or Supplemental Insurance), cover between 20 days and 100 days. There are even some insurances that cover half the cost per day during the first 100 days. The issue or problem arises upon the end of the insurance.
Upon exhausting all insurances or in cases where there are long term care insurances that pay part of the daily cost, the family is faced with the following dilemma. Either to privately pay or apply for Medicaid. Married couple are responsible for each other and without professional assistance will be required to pay their spouse’s medical expenses, such as nursing home care.
There are basically two types of Medicaid nursing home applications. One for a married person and one for a single person. In 2023 all nursing home applicants are allowed to retain $28,133 in resources and $50 in income. Additionally, they are allowed to pay for their supplemental health insurance if any, prescription premiums and funeral expenses. Let’s consider the following situation.
Applicant has $400,000!
In the first situation we have married couple:
Here, the ill spouse transfers all of the assets to the well spouse one month and the ill spouse becomes financially eligible the following month.
The more complex application is the application for a single person:
First option is to spenddown the assets. This means using the assets above the $28,133 to pay privately the nursing home expenses until the applicant becomes financially eligible. Second option is to hire a professional who is familiar with Medicaid’s rules and regulations and applies the allowed tools to protect a good potion of the applicant’s resources.
We at Elder Care Services, Inc., are strongly committed to protect as much as possible of the applicant’s resources and allow them the ability to afford things that Medicaid does not provide.
We file applications in NY County, which includes Manhattan, Brooklyn, The Bronx, Queens and Staten Island, as well as, Nassau, Suffolk, Rockland, Sullivan, Putnam, Orange, and Dutchess Counties.