Medicaid is a federal and state program that provides health coverage for certain people with limited income and assets Assets are resources such as savings and checking accounts, stocks, bonds, mutual funds, retirement accounts, and real estate. . Each state runs different Medicaid-funded programs for different groups of people, including:
- Older adults
- People with disabilities
- Children
- Pregnant people
- Parents and/or caretakers of children
All states also have Medicaid programs for people with limited incomes and assets who need nursing home A nursing home, also called a long-term care facility, is a residential facility for people with chronic illness or disability. Nursing home services include room and board, nursing care, personal care, and therapy services. A skilled nursing facility (SNF) is a nursing home that provides skilled care, but not all nursing homes are SNFs. Medicare does not cover the cost of nursing homes that are not SNFs. care, long-term care services, and home health care Home health care is care provided at home to treat an illness or injury. Medicare will only cover home health care if you are homebound and have a need for skilled care, including skilled nursing and/or skilled therapy services. services. Some states also have programs for individual adults who don’t fit any of these categories.
Each state uses financial eligibility guidelines to determine whether you are eligible for Medicaid coverage. Generally, your income and assets must be below a certain amount to qualify, but this amount varies from state to state and from program to program. You are eligible for Medicaid if you fall into an eligible group and meet that group’s financial eligibility requirements.
If you are eligible for Medicare and Medicaid (dually eligible), you can enroll in both. Medicaid can cover services that Medicare does not, like long-term care. It can also pick up Medicare’s out-of-pocket costs (deductibles, coinsurances, copayments).
Some states offer a Medicaid spend-down program or medically needy program for individuals with incomes over their state’s eligibility requirements. A spend-down program allows you to deduct your medical expenses from your income so that you can qualify for Medicaid. Contact your local Medicaid office to learn if a spend-down is available in your state.