Medicaid applications may be made with the Department for Medicaid Services. Following this process, it may take up to 45 days for your eligibility to be determined. The process can be easier if you are prepared prior to your meeting. Please bring the following items, as the Medicaid caseworker will request from you:
A state-funded program that helps individuals pay for medical costs such as doctor’s care, hospital stays, medications and skilled nursing facility care. You may be eligible for Medicaid benefits if you meet the eligibility requirements, which varies by state.
Individuals are currently allowed to have cash reserves or other assets totaling a set maximum set by the state-specific program, and excludes a non-revocable prepaid burial contract, subject to limitations set by the Medicaid Program Office. If you have a spouse living at home, he or she may be able to keep a portion of your income and your savings to meet his or her living expenses and needs. Further, your spouse can request an assessment to determine the extent of non-exempt resources at the time of admission.
A representative from the Department for Medicaid Services can review your financial information to determine and/or explain the eligibility for enrolling in the Medicaid benefit program. The date you qualify for benefits can also be determined. An application must be made. If you are unable to submit this application on your own, a family member, legal representative or another person who knows about your circumstances may assist you.
The facility, if certified by the state Medicaid program, cannot refuse to admit you, nor may the facility discharge you solely because you receive Medicaid to help pay for the cost of your care. Please let the Business Office Manager know if you have applied for Medicaid or if you decide to apply at a later date. Once your Medicaid application has been approved, the facility will review your past statements to refund any overpayments made during the approval process.
There are some supplies and services that are not covered. Please contact the Business Office Manager or the Social Services department for the most current information. The below are examples of some items and services that may not be covered:
Part A assists in paying for an inpatient stay in a skilled nursing facility. Part A has deductibles and co-insurance requirements. Most covered individuals do not have to pay premiums for the Part A benefits.
Medicare Part A will only pay for skilled nursing care in a facility certified to participate in the Medicare program, and will cover up to 100 days per spell of illness. To be eligible for utilizing the Medicare benefits for skilled nursing care, your care needs must meet certain criteria, such as:
Information regarding benefits under Medicare and Medicaid is available from our Admissions team, the Administrator or Social Services. The information below is general, and the programs are subject to change.
Medicare – a Federal health insurance program for individuals who are 65 years or older, have been disabled for at least two consecutive years, have been diagnosed with End-Stage Renal Disease or meet eligibility based on other criteria set by the Medicare program.
Medicare Part A will only pay for skilled nursing care in a facility certified to participate in the Medicare program, and will cover up to 100 days per spell of illness. To be eligible for utilizing the Medicare benefits for skilled nursing care, your care needs must meet certain criteria. (Read the complete article below for further information.)
You may be eligible for Medicaid benefits if you meet the eligibility requirements, which varies by state.
(Read the complete article below for further information.)
When private pay residents come close to exhausting their own resources, they generally become eligible for Medicaid. Our business office staff will assist you and your family with options and process.