Medicaid
- Medicaid covers many services that Medicare does not, including nursing home care,
outpatient prescription drugs, and home care.
- Eligibility requirements are strict. In general, monthly income cannot exceed $300
to $500 and total assets may be limited to about $2,000. Be sure to learn your state’s
specific rules about income and assets.
- Many nursing facilities do not accept Medicaid for payment, and those that do may
not meet your needs or standards.
Medicaid is a joint federal and state program that helps cover medical costs for
people with low incomes and limited resources. Medicaid programs vary from state
to state. Many Medicaid programs offer coverage for needs like nursing home care,
home care, and outpatient prescription drugs that aren't covered by Medicare. Most
state Medicaid programs cover a range of additional services, which may include
dental services, physical therapy, prescription medications, eye exams and glasses,
hearing aids, prosthetic devices, dentures, and more.
Older adults who are on Medicaid don’t have to pay their Medicare premiums or deductibles.
Medicaid makes payments directly to healthcare providers, not to you or your loved
one. Depending on the state your loved one lives in, he or she may have to make
a small copayment for some medical services.
Who is eligible?
Medicaid is primarily for low-income individuals. People who receive Supplemental
Security Income from the Social Security Administration are eligible for Medicaid
in every state.
The exact limits vary by state, but as a rough guide, the maximum monthly income
is about $300 to $500, and total assets are limited to about $2,000 (not including
a home, car, or personal possessions).
In some states, people who have higher incomes may qualify for home and community-based
services if they require the level of medical care provided in a nursing home. Different
states also have different rules related to “spending down,” the process of exhausting
one’s personal assets before qualifying for Medicaid.
How can my loved one apply for Medicaid?
Contact the Department of Social Services in your loved one’s state to learn where
and how to apply. Applying for Medicaid often involves plenty of paperwork, as well
as appointments with staff. If possible, gather financial records and fill out paperwork
before appointments.
Next Step: To learn more about qualifying and applying for Medicaid and other programs in your state, contact your state’s Department of Social Services.