Medicaid Programs

As our elder population continues to grow, so does the need for longterm care for our senior citizens. Many seniors, along with their families and caregivers, are finding it harder to afford the continuous care they require. If your loved one is having a difficult time paying privately for their short-term care or longterm care stay, there may be state assistance that can help. Medicaid is one type of state assistance which helps to provide some financial relief for aging individuals and offers several different plans that may be beneficial to the loved one or resident.

How do you know what options are best for your loved one or resident?

Long-term care facilities have become increasingly expensive over the years and most insurance policies do not cover a private nursing home stay. When this happens, it is best to know which direction to take in order to help your loved one or resident. Medicaid has several different options that may fit the needs of your loved one or resident. A traditional Medicaid plan may be what the patient needs if they are going to be long-term care or are considered financially destitute. Traditional Medicaid allows the patient to stay in long-term care and use a portion of his or her monthly benefits, i.e. social security, pension or retirement, as part of the “share of cost”. The state then helps to pick up the remainder of what was not paid. Medicaid Waiver programs help the patient/resident to enter into short term care. This normally includes rehabilitation or home care services. The waiver program was designed to help the patient save on the medical services provided so that they are able to keep their home in the community. The Medicaid Waiver program is usually a short-term program but can follow the patient/resident back into the community for in-home care. Managed Medicaid plans are generally much like the traditional Medicaid plans but are owned and operated
by private insurance companies.
Most of the Managed Medicaid programs need approval before a patient is able to admit and receive treatment in your facility. Generally, Managed Medicaid plans follow pricing guidelines with your facility. There are many more programs available depending upon the area that you are in. Check with your local Area on Aging office to see what programs may be available for your loved one or resident.

Missie Bramhall,
HHS Solutions Billing Manager