Submitted by: Goldie Ribiat
One should not think they must enter a nursing home in order to qualify for Medicaid benefits. In fact, if you require services at home, you can even keep your car and your house and still qualify for Medicaid. There are many different programs and the regulations are different for each one.
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Because Medicaid requires a 5-year lookback the application process can be quite frustrating. Medicaid is the only long-term payor source and a necessity for our senior communities. When someone’s cost of care begins to cost more than their income, they may be too late to begin the planning for Medicaid benefits as they have now entered the phase we like to call “spend-down”. This means that they are decreasing their net worth monthly and as additional costs arise, they will be closer to requiring Medicaid benefits. Medicaid truly is a great program that allows those that require coverage to receive care with dignity. Medicaid covers a lot of services including for those in nursing homes, assisted livings, and many more for those living at home.
Now more than ever due to COVID many of those that require long-term services are choosing to stay at home and utilize the home care benefits. One can receive aid, meals on wheels, pharmacy, transportation among others, and many other benefits. It is especially trying to have to consider moving into a nursing home or assisted living but have limited options for visitors. Choosing a placement and determining the best option for care is the easy part. The Medicaid application still requires the same level of scrutiny whether you are applying for services to remain at home, an assisted living, or a nursing home.
Of course, the regulations for Medicaid are specific and one must truly qualify for benefits. Regardless of where you choose to receive your care, it is important to know that there will be a lot of financial restrictions moving forward. It is imperative to project as best as possible what needs need to be taken care of while you are still in spend down. A prime example would be a prepaid burial service. Since the state of NJ allows for an individual to pay for this it is prudent to make sure this is taken care of prior to running out of funds. While you can feel confident your medical needs will be taken care of, this is a sure way to be sure your final wishes will be respected.
While Medicaid can only approve those that do meet the required specifications for the financial and medical component of the program knowing what all this is can help the planning to ensure all future needs will continue to be provided for.
Everyone has expenses that are unique to them. If you would like to discuss your specific needs please don’t hesitate to reach out!
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