Medicaid

Clearing up the misconceptions By Bruce Weaver, MPA, PA-C, Owner, AAging Better In-Home Care

Myths abound when it comes to understanding a state program called Medicaid. Most of us know about Medicare, which covers hospitalizations, medical bills and prescriptions for those over 65 years of age.

However, many are not aware that there is another program called Medicaid that will pay, among other things, services for in-home care when seniors become too frail to care for themselves. This program is funded by state funds along with matching funds from the federal government. But the catch for most individuals is that this program is based on income levels, and this is where many misconceptions arise.

One of the more common myths is that you have to give away or sell most of your resources to get Medicaid. The truth is that a person is permitted to own some property and still be eligible for Medicaid. The trick comes in knowing what is “countable” and what is “non-countable” under Medicaid rules. A certain amount of equity in a couple’s primary home can be non-countable in determining whether the husband or wife (or both) are eligible for assistance from Medicaid. And there are other types of non-countable property, such as extensive funeral planning and burial spaces purchased before a couple passes away. In essence, a person doesn’t need to be completely “broke” or without assets to become Medicaid eligible.

Another common myth encountered by families considering whether to place mom or dad in a nursing home is that Medicare will cover the cost. In fact, Medicare only pays for a small amount of the care provided by nursing homes in this country. Many families and elderly are surprised to learn this. Medicare only pays if you’re discharged from a hospital after at least a three-day stay. And if you still need skilled nursing care after a period of close to three months, you will have to pay privately for it unless you happen to have a long-term care insurance policy that covers nursing home costs—or unless you can qualify for Medicaid.

In contrast, almost all surveys of baby boomers or elderly adults show that “aging in place” in their homes is far more preferable than being moved into a nursing home when illness or frailty becomes a problem. In addition, health departments across the nation are finding that paying for certain Medicaid-eligible residents to stay in nursing homes is far more expensive than paying for their care at home. Because of this, Idaho’s Department of Health & Welfare is working toward approving more residents for services at home under the care of a Medicaid-approved Home Care company.

When considering care at home versus a nursing home, contact the local Medicaid unit to determine the person’s eligibility. Secondly, researching approved Home Care agencies in the area allows a family or individual to find out exactly what services are offered. And, finally, consulting with an elder law attorney would provide information on the consequences of accepting Medicaid. With proper preparations and planning, aging at home can be cost-effective, safe and satisfying.

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