This blog post is designed to provide general information on the subjects covered. It is not, however, intended to provide specific estate planning, insurance, tax or legal advice. Please note that LTC Consumer and its representatives do not give financial planning, tax or legal advice. You are encouraged to consult with your tax advisor or attorney concerning your own situation.

Medicaid Long Term Care – What Does It Cover?

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Some may think Medicaid long term care will pay for all of their needs in the future. While this may be true for some, Medicaid isn’t designed or funded to cover long term care services for everyone.

Medicaid, the government welfare program, typically requires that you have $2,000 or less in qualified assets to be eligible and then only covers “nursing homes that accept Medicaid Welfare patients.” It is a joint federal and state government program that can vary in eligibility by your state of residence. In general, Medicaid helps pay for some or all of the health care bills for individuals with low income and assets. It may also cover certain types of long term care services.

So, what long term care services does Medicaid cover? Here’s what you need to know.

Nursing Home Services

Nursing home services offer 24-hour care for those who need it. Though specific services may vary by facility, nursing homes offer skilled care given by a registered nurse and custodial care such as bathing, eating, and dressing. Medicaid covers nursing home services for eligible patients age 21 and older.

Home Care Services

Home care services are an alternative option to nursing home care to help individuals stay in their home. These services often include help with personal care services (bathing, eating, dressing, transferring from a chair to a bed, etc.), cleaning the house, and helping with laundry.

Medicaid eligible patients may not need 24/7 care. Home care services can be used a couple hours a day or a few days a week as needed.

Community-Based Services

Community-based services, often combined with home care services, offer support to help individuals stay in their home. These services often include:

  • Senior centers
  • Adult day service programs
  • Meal programs
  • Transportation services
  • Respite care

What Medicaid Doesn’t Cover

Medicaid will not pay for your mortgage, rent, utilities, or food. Only in select states does Medicaid pay for assisted living services in a facility. Check to see whether your state Medicaid program offers alternatives to nursing home services.

Keep in mind, Medicaid programs and eligibility for services may vary from state to state. Services available in your state, may not be available in another. Contact your state Medicaid office to learn about your state’s eligibility requirements and specific services available.

What If I Don’t Qualify for Medicaid? What Are My Options?

If you don’t qualify for long term care services through your state Medicaid program, you have four basic planning options.

  1. Do nothing
  2. Depend on your family and friends
  3. Self-insure
  4. Buy insurance

Thinking about future care needs isn’t something people like to dwell on. Many do nothing until it’s too late.

Others may choose to rely on family and friends to help care for them. It’s important to let your family know if this is your decision so they can prepare for it.

Some may self-insure if they have the funds available to pay for their own care, and others may invest in long term care insurance to help offset the cost of paying for care.

If you don’t qualify for Medicaid, what’s your long term care plan?

LTC Consumer is an independent, free online service to help consumers understand what long term care insurance is, how it works, and how to evaluate coverage options. Our mission is to provide an educational, no-pressure resource for learning about long term care planning, with the opportunity to speak with specialists who can help them.

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