Understanding Medicaid Rules, Regulations & Eligibility

November 30th, 2017 by John Wilson

One of the most complicated aspects of getting older is determining how to get the medical coverage you need to get through life without amassing major bills. Because most seniors don’t have access to company health insurance any longer, Medicaid often becomes a suitable choice to help cover some of these costs, particularly for seniors who are on a limited income. In fact, Medicaid can often come to the rescue when it comes to assisted living care in Oklahoma City, providing everyone with the opportunity to live in these types of environments.

Determining Eligibility

Before you rely on Medicaid to pay for assisted living communities in OKC, you will have to determine your elderly loved one is eligible for this type of insurance. Unlike Medicare, this type of insurance is operated on a state level and will vary by state. However, there are some general requirements that can help you determine if seniors may obtain coverage under Medicaid. Because of Medicare, federal law states seniors can only use Medicaid to pay for long-term care, rather than their day-to-day medical expenses. However, there are restrictions to this type of coverage, which are important to understand before you consider obtaining a policy for your loved one.

When determining eligibility for Medicaid, the state will look closely at the individual’s assets. In general, it is required for seniors to spend all of their existing assets before they can use Medicaid to pay for their long-term care, including assisted living care. However, it’s also important to note any large ticket purchases in the time leading up to the need for this type of care will be under tight scrutiny and could lead to ineligibility.

Medicaid may be accepted by assisted living communities.

Some assisted living communities accept Medicaid.

What Is Covered?

After you determine whether your senior loved one is eligible for long-term care insurance under Medicaid, you will need to explore what is covered under the policy. In many cases, Medicaid will be limited to certain types of long-term care, such as nursing homes, rehabilitation or skilled nursing services. However, if your loved one requires affordable assisted living in Oklahoma City due to a mental or physical ailment that affects their ability to live on their own, it may be covered under Medicaid when the appropriate requirements are met.

It’s important to recognize not all states allow for the use of Medicaid funds for assisted living purposes. In some cases, the insurance will cover any type of personal care, regardless of the place of residence, while others provide waivers that allow Medicaid to be used for assisted living. You should inquire with your state’s Medicaid program to determine if Medicaid will provide the level of coverage you need to pay for long-term care in an assisted living facility.

Most people focus more on obtaining Medicare for the elderly because this is the primary way to cover a variety of medical expenses. However, for those who will require long-term care, Medicaid may be a good way to help pay for assisted living expenses.

If you’re looking for information on how to fund assisted living care in Oklahoma City, contact us. We can help you find the coverage and assistance you need to make this option more affordable.

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