When will Medicaid pay for a nursing home?

Jun 15, 2023

Medical care is expensive, particularly when a patient has needs that are long-term or expected to last for the rest of his or her life. As individuals age, they typically need more assistance, and at some point, they may be unable to remain in their homes or live independently. At this point, it may be necessary for that person to move into a nursing home. Nursing home care, as you can imagine, is costly, and it is likely that a Florida patient lacks the financial resources to pay for this care out of pocket.

If you will need nursing care in the future or your loved one will require this type of support, you may benefit from an explanation of the financial impact of this need. There are times when Medicaid may cover this expense, but there are strict eligibility requirements. Before you make any decisions that could impact your future or your loved one, you may find it beneficial to learn about how you can secure help for long-term medical needs.

Eligibility requirements for Medicaid

For those who meet certain eligibility requirements, Medicaid could pay up to 100% of all nursing home expenses. However, the recipient cannot earn more than $2,382 individually per month, and countable resources must be worth less than $2,500. The income that could count toward this total includes pensions, retirement benefits, bank accounts, stocks and bonds, veteran benefits and more. When you apply for this coverage, Medicaid will typically look at your income and financial records from the last five years.

What Medicaid does not cover

Even with Medicaid coverage, there are certain things for which the recipient may have to pay out of pocket. This could include a private room, electronics, comfort items, magazines, gifts, extra food and more. If someone is not initially eligible for Medicaid coverage for nursing home care due to his or her income or assets, it may be prudent to reapply after first using all available resources.

Planning for the future

Planning for nursing home care can be a daunting and complex process. It is beneficial for someone considering this potential cost to make plans ahead of time. Planning for potential medical needs is a critical part of the estate planning process, and it will be in one’s interests to seek guidance regarding how to create a strategy that provides confidence regarding the future.

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