Once people reach the age of 65, they often assume their medical care will be covered by government benefits in one form or another. Unfortunately, nursing home costs are only covered if an applicant meets very specific qualifications.
If you take the right preparatory steps and establish your eligibility, Medicaid can provide long-term care benefits to pay for nursing home costs. At Huizenga Law, we work with individuals and families to develop strategies to qualify for nursing home care assistance.
Medicare Doesn’t Provide Much Help
Much of the care provided in a nursing home involves daily activities such as bathing, getting dressed, eating, and using the toilet. This is sometimes called custodial care. Medicare doesn’t cover this type of care. Medicare will cover some skilled nursing facility care such as services to treat, manage, and observe a medical condition. Skilled medical care includes treament such as IV injections and physical therapy.
Medicare will pay for up to 100 days in a skilled nursing facility if a patient is eligible. After 20 days, patients must make substantial co-insurance payments. Even when Medicare does pay, it’s only a temporary solution when a patient needs particular care to recover after a hospital stay. Medicare may pay for some services in a nursing home, but overall long-term care is not part of the program.
Long-Term Support Services Through Iowa Medicaid
The Medicaid program in Iowa offers a variety of support services to serve eligible individuals in their home or in a facility. These include:
- Home and community-based services such as home health, private duty nursing, and hospice services
- Intermediate care facilities for individuals with intellectual disabilities
- Residential care facilities for individuals who need supports other than nursing care
- Nursing facilities
- Skilled nursing facilities
Medicaid can help with the cost of care in nursing facilities for those who meet both the financial and medical qualifications.
Eligibility for Medicaid Benefits to Cover Nursing Home Costs
To receive assistance with nursing home care costs through Medicaid, you must demonstrate that you have limited income and very limited assets. Additionally, you must show that you fall within certain “eligibility groups.” Essentially, you need to prove that the person applying for nursing facility benefits needs the level of care that the facility provides.
For most people, the financial eligibility requirements are more difficult to satisfy. An individual’s income (from virtually all sources) can’t be more than $2,742 per month. In addition, the applicant cannot own more than $2,000 in countable assets. This includes not only cash and investments, but also all other forms of property. There are some assets treated as exempt or non-countable for eligibility purposes. This includes clothes, furniture, and sometimes the family home. A spouse who is not applying for nursing home benefits can keep half of the jointly-owned marital assets up to a value of $148,620.
While many people expect to pay for nursing home costs on their own until they are essentially out of money, there are ways to transfer assets and protect them so that all resources don’t need to be expended on nursing home fees before establishing Medicaid eligibility.
Get the Right Plan to Qualify for Nursing Home Benefits Through Medicaid
Advance planning makes a world of difference when it comes to paying for the cost of long-term care. Medicaid uses a five year lookback rule, so assets you transfer or give away in advance will not subject you to penalties that delay eligibility. Even if you need nursing home assistance suddenly due to a crisis, there are strategies to establish eligibility while conserving some assets.
The experienced team at Huizenga Law helps families protect their hard-earned assets while qualifying for long-term care benefits through Medicaid. Schedule a consultation today to learn how we can assist.
