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3 steps to help someone pay for long-term care with Medicaid

On Behalf of | Feb 4, 2024 | Medicaid |

Many older adults in Florida may eventually require state aid to ensure their comfort and well-being as they age. While most workers can potentially qualify for Medicare coverage after they retire, Medicare does have limitations on what treatments it covers.

Some people eventually realize that they need Medicaid benefits, not Medicare benefits. Long-term care needs often necessitate Medicaid coverage. Medicaid can pay for skilled nursing support in someone’s home and a room in a nursing home even though Medicare does not. The following steps are necessary to access Medicaid coverage for long-term care needs.

Step One: Performing a thorough review of finances

Someone’s personal finances have a direct impact on their eligibility for Medicaid. The state has very strict income limits. The state only grants a small personal allowance out of that monthly income, meaning even those who qualify may have to pay for some of their care with their own funds. There are also limits on personal property. An unmarried person applying for Medicaid coverage can only have $2,000 in countable assets. If a married person needs Medicaid but their spouse doesn’t, they could qualify with up to $150,000 in combined countable assets. In most cases, the home where someone lives doesn’t contribute toward the value of their countable assets unless the home is worth more than $688,000.

Step Two: Gathering medical documentation

One of the state review procedures for long-term care Medicaid applications looks at the necessity of long-term support. The state needs to agree with the applicant when they assert that they require the help of a nursing professional in their home or the more extensive support required by nursing home professionals. The more proof people have of their current medical challenges, the easier it may be for them to pass the review.

Step Three: Submitting documentation to the state

After reviewing personal finances and gathering medical records, applicants need to fill out paperwork to submit to the authorities. In some cases, they may need to appeal after the state denies their initial application. Given the strict financial rules for Medicaid applicants, planning long before someone experiences medical decline is often in their best interests. Individuals who properly prepare at least five years before they require long-term benefits may have an easier time initially qualifying. They can also diminish the likelihood that the state will pursue collection activity against their estate.

Taking the right steps when applying for Medicaid can increase someone’s chances of getting the support they need.