Got questions? Find answers about our services, Medicaid eligibility, and support for long-term care. Check out our FAQs for clarity.
We have shared some of the most frequently asked questions to help you out.
Medicaid’s long-term care (LTC) plan provides financial assistance for eligible individuals who require long-term medical and personal care services, such as in-home care, assisted living, or nursing home care.
Medicare primarily covers short-term rehabilitation and medical care, while Medicaid covers long-term custodial care for those who meet financial and medical eligibility requirements.
Medicaid covers nursing home care, home and community-based services (HCBS), personal care assistance, adult day care, and hospice care.
Yes, Medicaid offers home health services, including skilled nursing care, personal care assistance, and therapy services, depending on state-specific programs.
In many states, Medicaid helps cover some assisted living costs through Home and Community-Based Services (HCBS) waivers, but it does not typically cover room and board.
Yes, Medicaid is the largest payer of nursing home care in the U.S. It covers room, board, and medical services for eligible individuals in certified nursing facilities.
Private long-term care insurance is purchased separately and covers costs based on policy terms. Medicaid provides coverage based on financial need and medical eligibility.
Each state administers its own Medicaid program, so eligibility requirements, covered services, and reimbursement rates vary.
Eligibility is based on income, assets, and medical need. Generally, applicants must have low income and limited assets, though exemptions apply.
Income limits vary by state. In 2024, many states set a limit around $2,829 per month for individuals, but some allow a “Medicaid spend-down” process.
Most states allow individuals to keep up to $2,000 in countable assets, though some assets, like a primary home (up to a certain value), may be exempt.
Medicaid has a five-year look-back period for asset transfers. Giving away assets below market value can result in a penalty period of ineligibility.
Applicants must undergo a medical assessment to determine if they require a nursing-home level of care or similar support services.
Yes, Medicaid can deny coverage if an applicant does not meet income, asset, or medical eligibility requirements.
Applications are submitted through state Medicaid agencies, online, by phone, or in-person at local offices.
Approval can take 30 to 90 days, but processing may take longer if there are complications.
Applicants can appeal a Medicaid denial by requesting a fair hearing through their state Medicaid office.
Medicaid planning involves structuring assets and income legally to qualify for Medicaid while preserving wealth for a spouse or heirs.
Yes, Medicaid allows a primary residence exemption if the applicant intends to return home or if a spouse or dependent relative lives there.
Medicaid may require individuals to use personal assets to cover care costs until they reach asset limits, but exemptions apply.
A spend-down allows individuals with excess income to reduce it to Medicaid-eligible levels by paying for medical expenses.
Under Medicaid Estate Recovery, states may attempt to recover costs paid for long-term care from the recipient’s estate after death.
Yes, a spouse is entitled to retain a portion of the couple’s assets under Medicaid’s spousal impoverishment rules.
The CSRA allows the non-applicant spouse to keep a portion of the couple’s assets, usually between $29,724 and $154,140 (as of 2024).
Yes, irrevocable Medicaid asset protection trusts can help protect assets, but must be established at least five years before applying.
Yes, Medicaid allows applicants to set up irrevocable funeral trusts to reduce countable assets.
Certain Medicaid-compliant annuities can convert assets into income streams to help a spouse while preserving eligibility.
Yes, Medicaid covers memory care services in nursing homes and through HCBS waiver programs.
Some Medicaid programs allow individuals to hire family members as paid caregivers through consumer-directed care options.
Medicaid may cover home modifications, such as wheelchair ramps and bathroom safety improvements, under HCBS waivers.
Yes, Medicaid covers hospice care for terminally ill individuals.
Yes, Medicaid covers prescription drugs, often through Medicaid Managed Care or Medicare Part D.
Medicaid provides non-emergency medical transportation (NEMT) in many states.
No, Medicaid does not transfer between states. You must reapply in your new state of residence.
No, Medicaid does not force placement, but individuals must qualify for institutional care if seeking coverage.
Generally, Medicaid only covers care within the state where the individual qualifies.
It depends. Policies with a cash value may count as assets unless transferred or reduced.
Yes, but the reverse mortgage proceeds may count as income.
Yes, veterans can receive both, but VA Aid and Attendance benefits may affect Medicaid eligibility.
A lump sum inheritance may disqualify you until the funds are spent down.
Yes, applicants can appeal denials through their state’s Medicaid agency.
No, they depend on eligibility, funding, and availability.
Coverage continues as long as eligibility requirements are met.
Yes, if eligibility changes.
Yes, but typically for limited periods.
Yes, through HCBS waivers.
Yes, in most states.
Yes, typically annually.
Can Medicaid cover 24-hour in-home care?
Yes, depending on need.