Everything seemed to happen in a split second. One minute, 88-year old Mary Elizabeth was living at home and appeared able to care for herself. Then her son, Jason, received a call from the emergency room. Mary Elizabeth had suffered a devastating stroke and needed the kind of 24/7 nursing care best offered in a nursing home. She moved immediately from the hospital to a nursing facility, but financing her stay was a problem. Jason quickly learned about Nursing Home Medicaid Qualification and how quickly he could get her eligible.
The Basics of Nursing Home Medicaid Qualification
We’ve all heard of Medicaid, but may not understand the finer points of applying, qualifying, and finding the services we need.
Medicaid is federally funded, but state managed. Programs and eligibility requirements may vary from state to state. Alabama Medicaid offers a program for Institutional Medicaid – or Medicaid for nursing home residents.
Qualifying as a Nursing Home Resident
For Jason to get Medicaid for Mary Elizabeth, she has to meet the following criteria:
- Mary Elizabeth must be a U.S. citizen residing in Alabama.
- She must prove that her nursing care is needed for a medical condition.
- Mary Elizabeth must live in the nursing facility for at least 30 continuous days.
- She must have a monthly income below the current limit of $2,205 per month, although this amount may be adjusted in January of each year.
- Mary Elizabeth’s resources must be worth less than the limit Medicaid sets. At this time, the limit for an individual is $2,000. However, there are exceptions to this, particularly if the applicant is married.
But applying for government benefits can take months. Mary Elizabeth and Jason urgently need Medicaid coverage now.
Emergency Medicaid
It can take 45 to 90 days for a Medicaid application to be approved. However, Medicaid coverage may be granted to cover up to three months before the month in which the application was submitted. This applies if the applicant received medical care and if the applicant meets all other eligibility requirements.
One of the biggest obstacles to getting Medicaid immediately is that most people have more than $2,000 and are therefore “over resourced”. Medicaid requires that an applicant spend down their assets to $2,000 before they can qualify. There are planning strategies to protect some of your assets and still get qualified for Medicaid immediately.
Get a Decision on Medicaid as soon as Possible.
At Miller Estate and Elder Law, we work with families everyday who have loved ones in or going to a nursing home. We know the rules for Nursing Home Medicaid qualification. We can get you qualified quickly. Contact us at 256-251-2137 to schedule an appointment. We have offices in Birmingham and we have a new office located at 818 Leighton Avenue in Anniston. We serve clients in Gadsden, Hoover, Talladega, Oxford, Jacksonville, Vestavia Hills, and surrounding areas.