Medicaid is a government-administered health insurance program that provides coverage to low-income Americans during all stages of life, from birth to age 65+. Given the massive breadth of this program, it should not come as a shock that it’s an incredibly complex system, governed by a confusing set of rules. This article aims to answer the questions, what does Medicaid cover, and what does Medicaid NOT cover?
While Medicaid can support individuals of any age, it’s an especially excellent resource for seniors. Long-term nursing care costs in Alabama average $78,000 per year, and that is for a shared room. However, qualifying for Medicaid can be a challenge. Applicants must meet certain financial and medical eligibility requirements. There are strict income and asset limits, with policies designed to prevent individuals from giving away their assets in order to qualify. A qualified elder law attorney can help you navigate the Medicaid maze, and avoid unsuspecting mistakes that could leave you or a loved one without the coverage they need.
For seniors who qualify, Medicaid is a wonderful program that works in collaboration with Medicare to cover a variety of healthcare needs
What Does Medicaid Cover?
Medicaid covers mandatory healthcare services, including:
- Hospital care
- Skilled nursing
- Home healthcare
- Doctor’s appointments
- Preventative care & wellness screening
- Transportation to and from medical appointments
- Diagnostics
Optional benefits include hospice care, case management, prescription drugs, physical or occupational therapy, rehabilitation, dental, vision, and more.
However, Medicaid does have some limitations…
What Does Medicaid NOT Cover?
In most circumstances, Medicaid will not cover medical care provided outside of the United States, though certain circumstances—such as if a foreign hospital is closer than a domestic hospital—may be covered. Like with private health insurances, Medicaid will also not cover services deemed unnecessary, or services paid for by another insurance provider.
Some other services that Medicaid will not cover include:
- Free health screening or medical devices that are given away
- Cosmetic surgery or complications that result from cosmetic surgery
- Personal comfort items or beauty services
Every state has slightly different Medicaid qualifications and coverage, so the best way to gain comprehensive (and accurate) understanding is to speak with a qualified elder law attorney in your home state.
Miller Estate and Elder Law is happy to offer a number of free resources to help you better understand how Medicaid planning works, and how to avoid going broke paying for long-term care. Gain access to our brief 20-minute webinar about how to get you or a loved one qualified for Medicaid by completing the brief form below, or download one of our free guides.
