Medicaid Application Requirements
Costs for nursing homes can be daunting. If you’re eligible for Medicaid, this can help you defray these expenses.
Here’s what you should know.
Medicaid is available for those with significantly limited income, and you must meet strict requirements in order to qualify. The U.S. Department of Health and Housing Services offers an overview to Medicaid eligibility.
Video: Medicare and Medicaid
Those aged 65 or older with limited income and resources are eligible to apply for assistance with nursing-home care. For specific application and enrollment instructions, contact your state’s Medicaid office through the Benefits.gov website.
Differences Between Medicaid and Medicare
The government’s two major healthcare programs are Medicaid and Medicare. Though you may be eligible for both, each program has separate eligibility requirements and their services do not necessarily overlap. Review the details of each program to determine the best fit for you.
Medicaid is available to senior citizens with limited resources. Medicaid can pay for your Medicare premiums as well as other costs not covered by Medicare. Medicaid payments are made not to the individual, but rather sent directly to healthcare providers. Depending on your state’s requirements, you may be asked to provide partial payment for some services.
Medicare, on the other hand, is an entitlement program for which eligibility is based upon prepayment through employment or self-employment taxes.
How Can I Find Out About My Medicaid Benefits?
The Area Agency on Aging of Pasco-Pinellas, Inc., has an informative overview of Medicaid benefits. Programs providing full Medicaid benefits include:
Supplemental Security Income, which provides financial assistance to needy people 65 years or older- MEDS for Aged and Disabled, which serves a limited group of disabled people 65 years or older
- Institutional Care Program, which helps people 65 years or older and in nursing facilities pay for their care as well as general medical coverage. Strict level-of-care and income guidelines must be met.
- Aged Disabled Adult Waiver Program, which offers home and community-based services for those 60 and older.
- Long Term Care Diversion Program Waiver Program, which helps those 65 and older with nursing-home costs.
Consult the Medicaid page for your individual benefit information.
Video: Medicare and Medicaid Explanations
Medicaid Versus Medicare
Medicaid serves a low-income population. Eligibility factors may include:
- Age
- Physical conditions
- Income and resources
- Citizenship status
There are specific federal and state eligibility guidelines for Medicaid. Contact your state Medicaid organization to find out its specific eligibility requirements.
Medicare is designed to serve the following populations:
- People aged 65 or older
- People under the age of 65 with certain disabilities
- People of all ages with end-stage rental disease, or permanent kidney failure that requires dialysis or a kidney transplant
Medicare offers several components:
- Hospital insurance, which is prepaid through payroll taxes from you or a spouse and generally requires no premium.
- Medical insurance, which usually requires a monthly premium to help cover medical services and outpatient care, as well as various medical services not covered by the hospital-insurance component.
- Prescription drug coverage, which is available as of Jan. 1, 2006. This can help insulate against increased drug costs while lowering the price paid for prescriptions, and is provided by private companies.