What Is Long- Term Care Medicaid

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  • What Is Long-Term Care Medicaid

Medicaid is a government program that helps seniors and people with disabilities pay for long term care services. LTC Medicaid helps pay for services provided in nursing homes, assisted living facilities (not all states) and home-based care. The rules for Medicaid differ state by state.

For more information, visit Medicaid’s website at https://www.medicaid.gov/

Eligibility requirements

To be eligible for Medicaid, applicants must have income and assets below specific thresholds. For a single person, the asset limit is generally $2,000 in most states. However, if the Medicaid applicant has a spouse who does not need long-term care, the asset limit is significantly higher.  The Medicaid income limit varies by state.

Medicaid regulations prohibit the transfer of assets solely for the purpose of qualifying for benefits. The program conducts a thorough review, known as a “look back,” of financial transactions to ensure compliance with asset transfer rules. In most states, this review period extends to five years prior to the application date. 

Asset Evaluation and Medicaid Spenddown

Individuals seeking Medicaid benefits often have assets that exceed the Medicaid asset limit. To achieve eligibility, they must reduce their assets to the allowable limit, a process known as the Medicaid asset spend down. Medicaid has specific rules regarding which assets are included in the spenddown process and which are exempt (such as a primary residence or a car in certain cases). 

The process of determining the asset limit and Medicaid spenddown is complex and varies by state. This often creates a challenging situation for many individuals. Medicaid planning starts with an assessment of income and assets to identify the optimal spenddown strategy for achieving eligibility.

We’re here to help

The Medicaid application is time-consuming, and the rules and guidelines are complex. Due to the high cost of nursing care, an improper denial can cost you over $15,000 a month.  Medicaid caseworkers can be difficult to reach, and they may not prioritize your interests.  We handle the Medicaid application, track its review, and advocate against improper denials to reduce stress and confusion for you and your loved ones.