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Medicaid : Medicaid Planning : Nursing Homes : Estate Planning : Elder Law : Resources : Inheritance : Insurance

Medicaid is health insurance that helps many people who can't afford medical care pay for some or all of their medical bills.

Good health is important to everyone. If you can't afford to pay for medical care right now, Medicaid can make it possible for you to get the care that you need so that you can get healthy and stay healthy.

Medicaid is available only to certain low-income individuals and families who fit into an eligibility group that is recognized by federal and state law. Medicaid does not pay money to you; instead, it sends payments directly to your health care providers. Depending on your state's rules, you may also be asked to pay a small part of the cost (co-payment) for some medical services.

Overview of Medicaid

Title XIX of the Social Security Act is a Federal/State entitlement program that pays for medical assistance for certain individuals and families with low incomes and resources. This program, known as Medicaid, became law in 1965 as a cooperative venture jointly funded by the Federal and State governments (including the District of Columbia and the Territories) to assist States in furnishing medical assistance to eligible needy persons. Medicaid is the largest source of funding for medical and health-related services for America's poorest people.

Within broad national guidelines established by Federal statutes, regulations, and policies, each State (1) establishes its own eligibility standards; (2) determines the type, amount, duration, and scope of services; (3) sets the rate of payment for services; and (4) administers its own program. Medicaid policies for eligibility, services, and payment are complex and vary considerably, even among States of similar size or geographic proximity. Thus, a person who is eligible for Medicaid in one State may not be eligible in another State, and the services provided by one State may differ considerably in amount, duration, or scope from services provided in a similar or neighboring State. In addition, State legislatures may change Medicaid eligibility, services, and/or reimbursement during the year.

Basis of Eligibility

Medicaid does not provide medical assistance for all poor persons. Under the broadest provisions of the Federal statute, Medicaid does not provide health care services even for very poor persons unless they are in one of the groups designated below. Low income is only one test for Medicaid eligibility for those within these groups; their resources also are tested against threshold levels (as determined by each State within Federal guidelines).

States generally have broad discretion in determining which groups their Medicaid programs will cover and the financial criteria for Medicaid eligibility. To be eligible for Federal funds, however, States are required to provide Medicaid coverage for certain individuals who receive federally assisted income-maintenance payments, as well as for related groups not receiving cash payments. In addition to their Medicaid programs, most States have additional "State-only" programs to provide medical assistance for specified poor persons who do not qualify for Medicaid. Federal funds are not provided for State-only programs.

The following enumerates the mandatory Medicaid "categorically needy" eligibility groups for which Federal matching funds are provided:

  • Individuals are generally eligible for Medicaid if they meet the requirements for the Aid to Families with Dependent Children (AFDC) program that were in effect in their State on July 16, 1996.
  • Children under age 6 whose family income is at or below 133 percent of the Federal poverty level (FPL).
  • Pregnant women whose family income is below 133 percent of the FPL (services to these women are limited to those related to pregnancy, complications of pregnancy, delivery, and postpartum care).
  • Supplemental Security Income (SSI) recipients in most States (some States use more restrictive Medicaid eligibility requirements that pre-date SSI).
  • Recipients of adoption or foster care assistance under Title IV of the Social Security Act.
  • Special protected groups (typically individuals who lose their cash assistance due to earnings from work or from increased Social Security benefits, but who may keep Medicaid for a period of time).
  • All children born after September 30, 1983 who are under age 19, in families with incomes at or below the FPL.
  • Certain Medicare beneficiaries (described later).
Book The Medicaid Planning Handbook By Alexander Bove Jr.The Medicaid Planning Handbook : A Guide to Protecting Your Family's Assets from Catastropic Nursing Home Costs
Alexander Bove

Medicaid planning is essential if you want to leave the bulk of your estate to anyone. Many people are under the impression that Medicare fully covers the cost of a nursing home. This is not true. Under Medicare, for each benefit period, YOU pay: 1. Nothing for the first 20 days. 2. Up to $97 per day for days 21-100. 3. All costs beyond the 100th day in the benefit period. The Benefit Period begins the day you go to a hospital or skilled nursing facility. The Benefit Period ends when you have not received hospital or skilled nursing care for 60 days in a row. You must pay the inpatient hospital deductible for each benefit period. There is no limit to the number of benefit periods you can have.

Thus, if you stay beyond 100 days or indefinitely, due to an incapacitating illness like Alzheimer's, you will be required to pay out-of-pocket for all nursing home fees. The average monthly nursing home fees are between $6,000-$7000 per month. It doesn't take a genius to realize you could easily run through your life savings in very short order. If it is your intention to eventually transfer your estate to family or friends, without having it all be eaten up by nursing home costs, you need to act while you are still healthy.

To qualify for Medicaid, which does pay for full-time nursing home care, the value of your estate needs to be reduced to almost zero, three years prior to you requiring nursing home care. How you reduce your estate to almost zero is what medicaid planning is about. Many of the methods used to reduce your estate involve trust. There is also a little bit of statistics involved that requires you to determine when, if ever, you might begin to need nursing home care. It is highly recommended that you buy one of the books below or visit an elder law attorney who specializes in Estate Planning and Medicaid Planning. Trust me, from my own experience, this is the best ten or twenty bucks you'll ever spend in your life. We highly recommend this book as a first step toward understanding the issues involved in Medicaid Planning.

The Complete Idiot's Guide to Long-Term Care Planning

The Complete Idiot's Guide to Long-Term Care Planning
by Marilee Driscoll

How to Care For Your Parents' Money While Caring for Your Parents
How to Care For Your Parents' Money While Caring for Your Parents
by Sharon Burns, Raymond Forgue
Complete Idiot's Guide to Caring for Aging Parents

Complete Idiot's Guide to Caring for Aging Parents
by Linda M. Colvin Rhodes

Book The Beneficiary Workbook by Martin Shenkman

The Beneficiary Workbook
by Martin M. Shenkman

Book The Complete Eldercare Planner by Joy Loverde
The Complete Eldercare Planner : Where to Start, Which Questions to Ask, and How to Find Help
Joy Loverde
A Guide to Elder Planning: Everything You Need to Know to Protect Yourself Legally and Financially

A Guide to Elder Planning: Everything You Need to Know to Protect Yourself Legally and Financially
by Steve Weisman

How to Protect Your Life Savings : From Catastrophic Illness and Nursing Homes : A Handbook for Financial Survival

How to Protect Your Life Savings : From Catastrophic Illness and Nursing Homes : A Handbook for Financial Survival
by Harley Gordon

Book Beat the Nursing Home Trap

Beat the Nursing Home Trap : A Consumer's Guide to Assisted Living & Long-Term Care

Long Term Care Planning Guide 9th Ed. 1999 s

Long Term Care Planning Guide 9th Ed. 1999
by Phyllis R. Shelton

To find more information about Medicaid programs in your state, or to find a local Medicaid office in your state, click on one of the links below. Email us if you discover a bad link.
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas Medicaid
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington, D.C.
Washington
West Virginia
Wisconsin
Wyoming

 

  1. To Begin Again : A Journey Toward Comfort, Strength, and Faith in Difficult Times
    Naomi Levy / Knopf / October 1998
    Death & Grief

  2. A Broken Heart Still Beats: When Your Child Dies
    Anne McCracken(Editor), Mary Semel (Editor) / Hazelden Information Education / November 1998
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  3. On Death and Dying
    Elisabeth, Md. Kubler-Ross, Elisabeth Kbler-Ross / Collier Books / June 1997
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  4. How to Survive the Loss of a Love
    Melba Colgrove, et al / Prelude Pr / November 1993
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  5. Final Gifts : Understanding the Special Awareness, Needs, and Communications of the Dying
    Maggie Callanan, Patricia Kelley / Bantam Books / March 1997
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  6. Necessary Losses : The Loves, Illusions, Dependencies, and Impossible Expectations That All of Us Have to Give Up in Order to Grow
    Judith Viorst / Fireside / January 1998
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  7. Living with the End in Mind; A Practical Checklist for Living Life to the Fullest by Embracing Your Mortality
    Erin Tierney Kramp, et al / Three Rivers Press / September 1998
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  8. Motherless Daughters : The Legacy of Loss
    Hope Edelman / Delta / May 1995
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  9. A Grief Observed
    C. S. Lewis, Chad Walsh (Afterword) / Bantam Books / March 1, 1983
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  10. The Denial of Death (Free Press Paperback)
    Ernest Becker, Daniel P. Goleman / Free Press / April 1997
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  11. Beyond Grief : A Guide for Recovering from the Death of a Loved One
    Carol Staudacher / New Harbinger Pubns / April 1987
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  12. Good Grief : A Constructive Approach to the Problem of Loss [LARGE PRINT]
    Granger E. Westberg / Fortress Pr / February 1986
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  13. The Grief Recovery Handbook : The Action Program for Moving Beyond Death Divorce, and Other Losses
    John W. James(Introduction), Russell Friedman (Introduction) / Harpercollins / June 1998
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  14. The Wheel of Life : A Memoir of Living and Dying
    Elisabeth Kubler-Ross, Todd Gold (Contributor) / Touchstone Books / June 1998
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  15. When Parents Die : A Guide for Adults
    Edward Myers / Penguin USA (Paper) / March 1997
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  16. Cold Noses at the Pearly Gates
    Gary Kurz / Cold Noses / April 1997
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  17. After Goodbye : How to Begin Again After the Death of Someone You Love
    Ted Menten, Theodore Menten / Running Pr / May 1994
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  18. Who Dies? : An Investigation of Conscious Living and Conscious Dying
    Stephen Levine, Ondrea Levine / Anchor / February 1989
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  19. After the Darkest Hour the Sun Will Shine Again : A Parent's Guide to Coping With the Loss of a Child
    Elizabeth Mehren, Harold Kushner (Introduction) / Fireside / April 1997
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  20. The Loss of a Pet : New Revised and Expanded Edition
    Wallace Sife(Introduction) / Howell Book House / June 1998
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  21. The Courage to Grieve
    Judy Tatelbaum / HarperCollins (paper) / October 1984
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  22. Helping Children Cope With the Loss of a Loved One : A Guide for Grownups
    William C. Kroen, Pamela Espeland (Editor) / Free Spirit Pub / March 1996
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  23. Goodbye, Friend : Healing Wisdom for Anyone Who Has Ever Lost a Pet
    Gary Kowalski / Stillpoint Pub / October 1997
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  24. Healing After the Suicide of a Loved One
    Ann Smolin, et al / Fireside / June 1993
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  25. I'm Grieving As Fast As I Can : How Young Widows and Widowers Can Cope and Heal
    Linda Sones Feinberg / New Horizon Press / June 1994
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  26. Gentle Closings; How to Say Goodbye to Someone You Love
    Theodore Menten / Running Press Book Publishers / January 1992
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  27. The Presence of Absence : On Prayers and an Epiphany
    Doris Grumbach / Beacon Pr / August 1998
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  28. After-Death Communication : Final Farewells
    Louis E. Lagrand / Llewellyn Publications / June 1997
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  29. She Came to Live Out Loud : An Inspiring Family Journey Through Illness, Loss, and Grief
    Myra MacPherson, Kenneth J. Doka (Introduction) / Scribner / February 1999
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  30. How to Go on Living When Someone You Love Dies
    Therese, A., Ph.D. Rando / Bantam Books / August 1991
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  31. The Pagan Book of Living and Dying : Practical Rituals, Prayers, Blessings, and Meditations on Crossing over
    Starhawk, et al / Harper San Francisco / October 1997

  32. Empty Cradle, Broken Heart : Surviving the Death of Your Baby
    Deborah L., Phd Davis / Fulcrum Pub / March 1996
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  33. Helping Children Cope With Separation and Loss, Revised Edition
    Claudia Jewett Jarratt, Dan Rosenberg (Editor) / Harvard Common Pr / March 1994
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  34. Death : The Final Stage of Growth
    Elisabeth Kubler-Ross(Editor) / Simon & Schuster (Paper) / July 1997
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  35. Healing After Loss : Daily Meditations for Working Through Grief
    Martha Whitmore Hickman / Avon Books (Pap Trd) / December 1994
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  36. Letters from Motherless Daughters : Words of Courage, Grief, and Healing
    Hope Edelman(Editor) / Delta / May 1996
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  37. After Suicide
    John H. Hewett, Wayne E. Oates (Editor) / Westminster John Knox Pr / May 1980
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  38. Graceful Exits : How Great Beings Die : Death Stories of Tibetan, Hindu & Zen Masters
    Sushila Blackman(Editor) / Weatherhill / June 1997
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  39. Companion Through the Darkness : Inner Dialogues on Grief
    Stephanie Ericsson / Harperperennial Library / February 1993
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  40. The Rooms of Heaven : A Story of Love, Death, Grief, and the Afterlife
    Mary Allen / Knopf / February 1999
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  41. Lament for a Son
    Nicholas Wolterstorff / Wm. B. Eerdmans Publishing Co. / July 1987
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  42. After He's Gone : A Guide for Widowed and Divorced Women
    Barbara Tom Jowell, Donnette Schwisow (Contributor) / Birch Lane Pr / November 1997
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  43. The Measure of Our Days : A Spiritual Exploration of Illness
    Jerome Groopman / Penguin USA (Paper) / October 1998
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  44. The Grieving Child : A Parent's Guide
    Helen Fitzgerald, Elisabeth Kubler-Ross (Designer) / Fireside / July 1992
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  45. Dying Well : The Prospect for Growth at the End of Life [LARGE PRINT]
    Ira Byock / Riverhead Books / February 1997
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  46. The Bereaved Parent
    Harriet Sarnoff Schiff, Sarnoff Schiff / Viking Pr / November 1978
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  47. Widow to Widow : Thoughtful, Practical Ideas for Rebuilding Your Life : Challenges, Changes, Decision-Making & Relationships
    Genevieve Davis Ginsburg / Fisher Books / March 1998
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  48. The Worst Loss : How Families Heal from the Death of a Child
    Barbara D. Rosof / Henry Holt (Paper) / November 1995
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  49. Losing a Parent : Passage to a New Way of Living
    Alexandra Kennedy / Harper San Francisco / June 1991
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  50. Seven Choices : Taking the Steps to New Life After Losing Someone You Love
    Elizabeth Harper Neeld / Centerpoint Pr / June 1997
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  51. The Good Death : The New American Search to Reshape the End of Life
    Marilyn Webb, et al / Bantam Books / November 1997
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  52. The Dying Time : Practical Wisdom for the Dying and Their Caregivers
    Joan Furman, David McNabb (Contributor) / Random House (Paper) / September 1997
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  53. Facing Death and Finding Hope : A Guide to the Emotional and Spiritual Care of the Dying
    Christine Longaker / Doubleday / June 1998
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  54. Necessary Losses ~ Publisher Out Of Stock
    Judith Viorst / Fawcett Crest / August 1996

  55. Living With Death and Dying
    Elisabeth Kubler-Ross / MacMillan Publishing Company / June 1997
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  56. A Mother Loss Workbook : Healing Exercises for Daughters
    Diane Hambrook, et al / Harperperennial Library / September 1997
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  57. Unspeakable Losses : Understanding the Experience of Pregnancy Loss, Miscarriage, and Abortion
    Kim Kluger-Bell / W.W. Norton & Company / April 1998
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  58. No Time for Goodbyes : Coping With Sorrow, Anger, and Injustice After a Tragic Death
    Janice Harris Lord, Eugene D. Wheeler (Editor) / Pathfinder Pub / October 1991
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  59. After the Death of a Child : Living With Loss Through the Years
    Ann K. Finkbeiner / Johns Hopkins Univ Pr / June 1998

  60. Good Grief Rituals : Tools for Healing : A Healing Companion (Healing Companion)
    Elaine Childs-Gowell / Station Hill Press / October 1992
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  61. The Wheel of Life : A Memoir of Living and Dying
    Elisabeth, MD Kubler-Ross / Scribner / June 1997

  62. Silent Grief : Living in the Wake of Suicide (The Master Works Series)
    Christopher Lukas, Henry M. Seiden (Contributor) / Jason Aronson / June 1997
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  63. The Art of Dying : How to Leave This World With Dignity and Grace, at Peace With Yourself and Your Loved Ones
    Patricia Weenolsen, Bernie S. Siegel / St. Martin's Press / October 1997
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  64. Angel Pawprints : Reflections on the Loss of a Canine Companion
    Laurel E. Hunt(Introduction), Alice Villalobos / Darrowby Press / December 1998
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  65. Intimate Death : How the Dying Teach Us How to Live
    Marie De Hennezel, et al / Knopf / July 1998
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  66. Miscarriage : Women Sharing from the Heart
    Marie Allen, Shelly Marks / John Wiley & Sons / January 1993
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  67. I'm With You Now : A Guide Through Incurable Illness for Patients, Families, and Friends
    M. Catherine Ray / Bantam Books / July 1997
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  68. Living With Loss : Meditations for Grieving Widows (Days of Healing, Days of Change)
    Ellen Sue Stern / Bantam Doubleday Dell Pub (Trd Pap) / August 1995
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  69. After the Death of a Child : Living With Loss Through the Years
    Ann K. Finkbeiner / Free Press / May 1996
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  70. Cry Until You Laugh : Comforting Guidance for Coping With Grief
    Richard J. Obershaw / Fairview Pr / February 1998
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  71. Life After Loss : A Personal Guide Dealing With Death, Divorce, Job Change and Relocation
    Bob Deits / Fisher Books / September 1992
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  72. Talking About Death : A Dialogue Between Parent and Child
    Earl A. Grollman, Susan Avishai (Illustrator) / Beacon Pr / November 1991
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  73. Safe Passage : Words to Help the Grieving Hold Fast and Let Go ~ Publisher Out Of Stock
    Molly Fumia / Conari Pr / August 1992
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  74. Helping Children Grieve : When Someone They Love Dies
    Theresa Huntley / Augsburg Fortress Publications / October 1991
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  75. Reflections on Life After Life
    Raymond A. Moody / Bantam Books / August 1988
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