Medicaid Long Term Care State Qualifications

Although we are going to provide you with Medicaid long term care information, keep in mind that even though the federal government establishes general guidelines for the program, the Medicaid program requirements are actually established by each state and are funded by both the state and federal governments..

On the federal end of it is the Centers for Medicare and Medicaid Services (CMS) within the Department of Health and Human Services (HHS) that oversees both the Medicaid and Medicare programs. Nevertheless, here is a very general overview of how the various states and/or jurisdictions manage their programs:

Alaska, Idaho, Kansas, Nebraska, Nevada, Oregon, Utah, Northern Mariana Islands use the same rules to decide eligibility for Medicaid as SSA uses for SSI, but require the filing of a separate application.

Connecticut, Hawaii, Illinois, Indiana, Minnesota, Missouri, New Hampshire, North Dakota, Ohio, Oklahoma, Virginia, have their own eligibility rules that are different from SSA`s SSI rules. In these States a separate application for Medicaid must be filed.

The remainder of thirty-two states and the District of Columbia provide Medicaid eligibility to people eligible for Supplemental Security Income (SSI ) benefits. In these States, the SSI application is also the Medicaid application as they are coupled together. Additionally, although California is a state that falls into this category, in California the Medicaid program is called Medi-Cal, and is managed by the Department of Health Services.

To get the necessary information on your state specific Medicaid long-term care requirements, you can start by contacting your State Medical Assistance office. However, one applicable rule for all states and districts that became effective as of July 1, 2006, is that all Medicaid applicants must provide satisfactory documentary evidence of U.S. citizenship or nationality when either initially applying, or upon a Medicaid recipient's first Medicaid re-determination. This 2006 ruling falls under Public Law No.109-171 (Deficit Reduction Act of 2005, Section 6036).

As it applies to Medicaid long term care, Medicaid pays for some long-term care services at home, in the community, and in genrally covers nursing home care. Medicaid covers many groups of individuals but even within the groups, requirements must be met. Generally though, aside for providing the documents of citizenship, the requirement are based on meeting disability and income/resources guidelines. The rules for counting income and resources vary from state to state and from group to group. Also, there are special rules for those who live in nursing homes and for disabled children living at home.

Sometimes to meet personal resources/assets to qualify, those resources must be spend down. However, be warned, this should not be done without the advice of a qualified attorney as there are rules that govern the spending down of resources. One cannot simply give their resources to a family member or friend as States are required to investigate if such has been done. And investigate they do therefore if a state discovers that you gave away resourses you will be charged a penalty. The penalty is determined on a state basis and could mean a disastrous consequence such as a state that will immediately stop paying for a persons nursing home care.

In general, one should apply for Medicaid if they have limited income and resources. However, in many states the qualification are not miserly, nonetheless the services of an attorney who knows the rules of your states Medicaid long term care program, should be seriously considered.

Long Term Care