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Does My Elderly Parent Qualify for Medicaid?

Two senior women at home, hugging. Family and generations concept.

Do you have questions about which government-managed health insurance programs your elderly parents may be eligible for? MedicareInsurance.com is here to help! Feel free to call us by phone at (800) 950-0608 or reach out via our online chat feature to speak with a friendly and experienced live agent today.

Just the Essentials…

  • Medicaid is a healthcare insurance program designed specifically for low-income individuals, including seniors. It is managed jointly by the U.S. federal government and individual state governments.

  • Medicaid provides coverage for many essential healthcare needs, and this coverage can even be expanded depending on certain factors.

  • There are several income limits when it comes to Medicaid eligibility, but there are also many ways for an individual who is initially above the income limit to still qualify.

  • Medicaid eligibility requirements, benefits, and covered services may vary. It is important to check with your local Medicaid office for specific clarification.

What is Medicaid and how does it work?

Medicaid is a joint federal and state insurance program that provides insurance coverage to over 70.6 million Americans including the elderly. Since the Affordable Care Act was passed, many states have expanded Medicaid coverage to all-low income adults under 65. 

Despite increased awareness, the Medicaid program can still be a bit confusing to navigate. Learn why Medicaid is helpful to seniors, how eligibility for Medicaid is determined, what services are covered, what its financial limits are, and other important information right here at MedicareInsurance.com

Why Medicaid?

When it comes to enrolling in health care coverage, most seniors are primarily concerned with finding the right Medicare plan that works for them. However, it is important to note that Medicaid is a crucial part of insurance coverage for many seniors. If you are thinking about ways to lower healthcare costs for your elderly parents, applying for Medicaid is something to think about. 

Believe it or not, Medicaid can provide healthcare coverage for many seniors even before they retire. Those in their 50s or 60s often aren’t able to work due to physical limitations or have a difficult time finding work to begin with. Since healthcare costs can be higher for those who don’t have employer-sponsored health care, Medicaid is designed to fill the gap.

While Medicare Part B requires one to pay 20 percent coinsurance cost for services, Medicaid is responsible for paying coinsurance as well as Medicare premiums and deductibles. In addition, one may also be partially or fully covered for certain prescription drugs under Medicaid and the Extra Help program.

If you’re worried about your parents’ ability to pay for long-term care in a nursing home, you may not have to be. Often, Medicaid can help pay for this care as well. On average, nursing home care costs over $80,000 each year. In many cases, Medicaid is often the best (or sometimes, the only) option for seniors when it comes to affording expensive long-term care.

What Does Medicaid Cover?

Medicaid covers the same types of services that Medicare does including:

  • Hospital stays 
  • Nursing services
  • Lab tests
  • Treatment in a clinic 
  • Doctor services

Some state Medicaid programs may also cover other benefits like transportation, dental, vision, and hearing services.

Who is Eligible for Medicaid?

Medicaid currently provides healthcare coverage to approximately 7.2 million low-income seniors. Unlike Medicare, the eligibility requirements for Medicaid can vary depending on the state. Each state has different eligibility requirements, including different income requirements. 

Most seniors who are age 65 or older are eligible to apply for Medicaid. Generally, the less income your parent has, the more Medicaid will cover. In addition, Medicaid will typically cover Medicare Part B premiums up to a certain income level.

Income Limits for Medicaid Eligibility

The specific income limits for Medicaid eligibility depends on the state in which an applicant lives. If your parent is over the income limit specified by their state, they may benefit from putting excess income into a Qualified Income Trust. This way, certain income no longer counts toward the state income limit for Medicaid eligibility.

In a Qualified Income Trust, income is managed by someone else and must be used for very specific needs, such as payment for Medicare premiums or medical expenses that Medicaid does not cover.

You may also be able to reduce the income amount that counts toward Medicaid eligibility by spending income that is over eligibility limits on things like cost of care, debt, or the purchase of an irrevocable funeral trust.

Other important information about Medicaid.

Medicaid is a valuable resource for seniors, but it is important to remember that not every healthcare provider accepts Medicaid. For this reason, it is important to check with your parents’ doctor or other healthcare providers to determine what is and is not covered.

Many Medicaid recipients also have something called Managed Medicaid, a plan that works similarly to Medicare Advantage. With Managed Medicaid, there are no premiums or copayments required except for those resulting from optional services. Some states have multiple Managed Medicaid plans that your parents can choose from. 

More information about Medicaid plans and how they work can be obtained from your local Medicaid office.

If you have additional questions regarding Medicaid eligibility or how Medicaid works together with Medicare, don’t hesitate to contact MedicareInsurance.com via our online chat feature or by phone at (800) 950-0608 to speak with a live licensed agent today. Our team of experts will be happy to explain what options may be available.

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