Medicaid is a federal and state funded program that is administered by each state. It pays medical care costs for those who can’t afford them. Eligible individuals may be those age 65 and over, the blind, or the disabled.
In a word, YES. The Medicaid intake office requires an extensive amount of information: up to 5 years of bank statements, copies of all financial transactions, explanations concerning any transfers made during that time period, and copies of legal instruments, such as trusts and annuities. Failure to comply with requests for information could lead to loss of coverage or denial of benefits. Because of the amount of information required, it may take months to complete an application. With complications, it can take even longer.
The average cost of long-term nursing home care in New England is currently nearly $12,000 per month. The average stay in a nursing home is two years. To pay out-of-pocket for nursing home care for one resident for two full years, the cost would be approximately $288,000. If you qualify for Medicaid, your benefits may cover this cost completely.
The reality is, an average middle class family or individual cannot afford the cost of a nursing home stay—especially now, in this economic climate. Even if you start out paying out-of-pocket, sooner or later you will probably run out of money. We all will.
Most of us will need Medicaid at some point. In Connecticut, for example, about 70% of nursing home residents use Medicaid to pay for their care.
Though most of our clients are older adults, you do not need to be over 65 to be eligible for Medicaid. Individuals between the ages of 18 and 65 who are disabled or who have recently suffered a stroke, heart attack, dementia, Alzheimer’s, or some other acute need requiring nursing home care may be eligible.
It’s never too early to start planning. If you are approaching the time when you may need to enter a nursing home, consider how you will pay for your care.
If you are the spouse, child, grandchild, or other family member of someone who may need nursing home care, now is the time to begin learning about your options. Will you pay out-of-pocket? Do you have funds you’ve set aside for this day? Or will you need to spend down assets in order to qualify for Medicaid?
Whether this day is right around the corner or six months, a year, or two years in the future, you can begin planning now.
We would be happy to answer your Medicaid application questions. Feel free to give us a call at 877-514-1102 or 860-657-3058 or fill out our contact form and a case worker will contact you shortly with some help.