Medicaid Explained

Medicaid is a program maintained jointly by states and the federal government. It is designed to pay for home healthcare aids and/or nursing home care for individuals who qualify. How does one qualify for medicaid? Although medicaid is basically a welfare program, estate planning can allow even families with significant assets to qualify for medicaid benefits.

Medicaid Qualifications

In New York State, the department of social services is the government organization an individual must apply to in order to qualify for medicaid benefits. The department of Social Services considers 3 important factors when determining medicaid eligibility;

  • Does the individual applying for medicaid benefits need nursing home care and/or a home health care aid?
  • What is the income of the applicant and his or her spouse? This includes pension benefits, retirement accounts, investment income, rental income, Social Security and all other income received by the individual and or his or her spouse.
  • Both the individual and his or her spouse have assets that can be utilized to pay for home healthcare aids and or nursing home expenses. These assets include, investments, residence, savings and all other assets.
  • Two Medicaid Programs

    There are two types of medicaid programs available to individuals. First is called community based medicaid. This involves having a healthcare aid provide services in the applicant’s home to help the applicant with their daily needs.

    The second type of medicaid benefits is referred to as institutional medicaid. This involves medicaid covering the cost of the individual residing in a nursing home facility.

    Individuals applying for institutional medicaid will have to submit documentation of their finances for the past five years.

    Medicaid Eligibility and Elder Care Planning

    Proper estate planning can help families protect their assets and allow them to be inherited by future generations and still have the state to pick up the cost of community based medicaid and for institutional medicaid (nursing home expenses). Speaking to an experienced elder law attorney is the first step in planning for one’s future and the possibility of needing institutional healthcare services or community based healthcare services.

    Elliot S. Schlissel is an attorney practicing Elder Law for more than 35 years. He has helped numerous clients qualify for both community medicaid as well as institutional medicaid.