What Is Medicaid Long Term Care?

Medicaid is a program which combines federal and state funds, which can help pay for medical long term care for people who qualify for benefits. Medicaid looks at whether an applicant for benefits meets the requisite need for personal and medical care. Because Medicaid is means tested, the applicant must also satisfy income and asset eligibility criteria. Medicaid benefits can pay for medical needs not covered by Medicare, such as nursing home care and personal care services.

What Are the Eligibility Criteria for Medicaid?

Medicaid can provide medical and health coverage to seniors, persons with disabilities, pregnant women and children. Florida Medicaid programs for seniors have three basic eligibility criteria: the applicant needs assistance (medical and/or personal care); the applicant’s income is below an “income cap”; and, the applicant’s available assets do not exceed an “asset limit”. Medicaid can help pay for assistance at home; and, help pay towards the cost of assisted living and skilled nursing care in a nursing home. Although at first blush Medicaid may seem straightforward, it is in fact often counter-intuitive and confusing. Medicaid eligibility is based on Federal law and regulations promulgated by Social Security Administration, as implemented by the Florida Administrative Code, and regulations from the Florida Agency for Health Care Administration and the Florida Department of Children and Families. For a chart of financial eligibility standards for Florida Medicaid programs, go to:

http://www.dcf.state.fl.us/programs/access/docs/esspolicymanual/a_09.pdf

What is VA Aid and Attendance?

One program of the Veterans Administration which provides benefits for veterans and their spouses is known as “Aid and Attendance.” Like Medicaid, the Aid and Attendance program is means tested: assets and income are evaluated by the VA in conjunction with an applicant’s costs of care. The program is designed to provide monetary assistance to a veteran and their spouse who need assistance with their activities of daily living, when the veteran and their spouse do not have the financial resources or any other sources to pay for this assistance themselves. Basic eligibility criteria are: the veteran must have served in the United States Armed Forces during a period of “armed conflict” (i.e., World War II, Vietnam War, Korean War) for at least 90 days; the veteran must have received an honorable discharge; and the veteran (or their spouse, or, their surviving spouse if the veteran is deceased), must be medically determined to need assistance with certain activities of daily, and, the veteran does not have the financial resources or any other sources to pay for this assistance themselves. Examples of qualifying activities of daily living include: assistance and/cuing with bathing or showering; and, medication management.

If you have questions about Medicaid or VA Aid and Attendance, or need help with long term care planning, please contact our office.