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Medicaid Qualification

When the time comes to place a loved one into a Skilled Nursing Facility, often referred to as a nursing home, there are many difficult decisions to be made. These include: (1) what kind of care is required and what facility will provide the best care; (2) what is the cost of care and how does it vary from one facility to the next; (3) who will pay for the care, and (4) where can you turn for financial assistance. Our healthcare system can be difficult to navigate even for those who work within it, and the government benefit system is virtually incomprehensible.

Medicaid is the government benefit that provides certain long-term care benefits when specific medical and financial eligibility requirements are met. In 2005, the U.S. Congress passed the Deficit Reduction Act (DRA). That law made significant changes to the Medicaid eligibility rules, generally making them more restrictive. As of January 1, 2012, Illinois adopted its version of the DRA. Then, on July 1, 2012, Illinois passed the SMART Act, which promulgated additional rules that created an even more restrictive policy.

Even if you don't think that your loved one currently qualifies for Medicaid benefits, understanding the rules and how they are applied will ensure placement at the facility of your choice and for the continuation of proper and necessary care. It may allow you to preserve some of your own assets for your ongoing care. For veterans, coordinating Medicaid benefits with the VA pension benefit may substantially enhance the financial security of an eligible participant. It is also important to understand the relationship between Medicare and Medicaid, two completely separate and different government programs.

Schedule a consultation with one of our Elder Law attorneys today to discuss your long-term care options. We can help you determine your Medicaid eligibility requirements and how government programs and benefits can help to provide for your long-term care needs.

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