Qualifying for Nursing Home Medicaid is a complex process that comes with a lot of rules. Understanding all of these can be quite difficult, especially if you aren't familiar with the program. It is imperative that you learn a bit about what you can expect if the time comes for you to need this coverage.
The Nursing Home Medicaid program in Georgia is run by the federal and state governments. What do you need to know when considering your options?
Nursing Home Medicaid is needs-based
There are specific limits for income and resources that come with Nursing Home Medicaid. Limits are set for individuals and couples. It is sometimes possible to use Medicaid planning to help an individual meet the income and asset limits.
One thing that people who need to qualify for this program must not ever do is give assets away. You can face penalties for any assets that are given away in the 60-month period immediately prior to applying for the program. This is known as the lookback period.
Specific requirements must be met
One requirement that some people might not be aware of is that in order to qualify for Nursing Home Medicaid payments, the applicant must be a resident at a nursing home that is certified to accept the program's payments for at least 30 days. The person is also required to meet a Level of Care requirement as noted by a doctor.
There are three categories of impairments for Nursing Home Medicaid. An applicant must have a medical status that meets the requirements. On top of that, they must also have either a functional status or a mental status.
- Medical status: catheter care, nutrition management, vital sign monitoring, medication management, specialized nursing services, skin care maintenance or treatment, or specific forms of therapy less than five times per week
- Functional status: continence, mobility or feeding assistance; trouble communicating
- Mental status: behavior problems, memory issues beyond basic forgetfulness, poor decision making skills, cognitive problems that are undetermined
Finding legal ways to meet the requirements for Nursing Home Medicaid can be a complicated undertaking. Working with a professional who is familiar with the program and the planning options might be beneficial. It is imperative that you avoid taking action to reduce your income or assets until you speak to a professional and find out how the various options might impact your application.