|  | Healthcare Industry | Health Insurance

Does Medicaid Cover Nursing Homes?

Nursing home care is expensive. Fortunately, Medicaid helps cover some of the costs associated with long-term care. Unlike Medicare, you must meet certain eligibility criteria to receive coverage. In addition to income, there are asset limits. The nursing home must be approved by Medicaid. Many nursing homes or hospitals can assist you with the application process.

  1. Medical Criteria

    • To receive coverage for long-term care, treatment must be deemed necessary. The Department of Health and Rehabilitative Services (HRS) will determine medical eligibility. A doctor must evaluate your condition. if you are unable to do activities associated with daily life on your own, you may qualify for nursing home care.

    Income

    • The income limits vary in each state. All income is counted, including Social Security, pension, disability payments, interest and any other sources of income. In 2011, the income allowance for an individual ranges from $1,750 to $2,739 a month. If your spouse is also entering the nursing home, his income will have the same restriction. A healthy spouse, also referred to as a community spouse, does not have an income restriction. Any income that comes in your name is considered your income, even joint income.

    Resources

    • Although there are asset limitations, not all assets are counted. Your home is exempt, provided you plan to return or your spouse is living in the property. Your primary vehicle, personal possessions and some pre-paid funeral expenses are excluded also. An individual entering the nursing home is allowed $2,000 in countable assets. A couple entering the nursing home can have $3,000 in assets. The healthy spouse can have up to $109,560 in assets as of 2011.

    Spend-Down

    • If you exceed asset restrictions, you can enter the nursing home as a private-pay resident. Medicaid will allow you to "spend-down" your assets to receive coverage. Strict look-back laws do not allow you to give away assets within a five-year period prior to applying for coverage. If you give away assets, you may be penalized with a delay in Medicaid benefits.

Health Insurance - Related Articles