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Five Things All Seniors Should Know About Claiming Medicaid

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Most seniors are familiar with Medicare, but many are unaware they may also qualify for Medicaid, a separate federal and state-funded insurance program that offers a range of benefits, including dental care, prescription drug coverage, and nursing facility care. Here are five important things you should know about applying for Medicaid.

Medicare and Medicaid
Don’t assume you can’t get Medicaid just because you are have Medicare. Many seniors are dual eligibles, which means most of their health care costs are covered by Medicare and Medicaid together. If you have both Medicare and full Medicaid, you will receive your Part D prescriptions through Medicare and be automatically qualified for extra help paying for your coverage.

Spend Down Rules
If your income exceeds the income level for Medicaid in your state, you may still be eligible through the spend-down process to subtract medical expenses from your income. You may need to spend some income on hospital bills, medications, or other medical costs before you are eligible for Medicaid. Medicaid spend-down does need to be approached carefully, however.

Levels of Medicaid Coverage
Medicaid has tiers of coverage and four programs for dual-eligible people who can also receive Medicare. Depending on your situation, you may be a qualified Medicare beneficiary with the highest level of coverage, a low-income Medicare beneficiary to get Medicaid coverage for Part B premiums, a qualifying individual for help with Part B premiums, or a qualified disabled working individual for help with Part A premiums. Know where you fall and be sure to ask your local agency what you can use through your level.

Nursing Home Care
Unlike Medicare, Medicaid can provide long-term care coverage for those with little to no income and assets. If you have less than $2,000 in countable assets like investments and retirement savings, and receive less than $2,163 in countable income each month, you can likely qualify for Medicaid and nursing home coverage.

A Professional Can Help
Qualifying for Medicaid can be complicated, especially if your income is over the limit. There are many companies and law firms that specialize in helping people navigate their state’s complex laws to make wise healthcare decisions. Check with health law schools to see if they can direct you to someone who can help.

While the process of claiming Medicaid can seem complicated, you don’t need to navigate the complex laws surrounding benefits and eligibility standards alone. If you feel overwhelmed trying to do it on your own, reach out for help to find out if you qualify and whether you need to spend down your income first.