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Medicaid is government health insurance for individuals of all ages who have limited resources. Although the federal government sets guidelines for the program, each state has the flexibility to structure the program as they determine. An individual can be enrolled in both Medicare and Medicaid and as such, Medicaid can be of assistance to many older adults because it can help pay Medicare premiums and copays.


Medicaid Services

In addition to the healthcare services covered by Medicare, Medicaid will pay for long term care services, such as:

  • In-home care to assist with personal care, meal preparation, moving around the home, transportation, shopping, light housekeeping, laundry, etc..

  • Skilled nursing facilities - short and long term placement

  • Adult Day programs 

  • Case Management 

  • The following may also be available depending on the state:

    • Dental Care

    • Transportation

    • Special medical equipment

    • Home modifications

    • Assisted living or residential care facilities

    • Assisted technology and devices

    • Emergency response systems

    • Financial management service


  • The beneficiary must reside in the same state as where they are receiving Medicaid 

  • The beneficiary must be a US citizen or other qualified non-citizen such as a lawful permanent resident. 

  • Financial eligibility includes maximum income and asset amounts and can vary by state.  It is important to check the State Specific Medicaid Eligibility Requirements

    • If an individual’s income or assets are higher than the eligibility limit, they may still be eligible by “spending down” to meet the financial requirement.  Paying for certain medical and care expenses can be considered as a reduction in income and assets.

    • Many states have a Share of Cost program for those who meet the asset limit but not the income.  With Share of Cost, an individual pays out-of-pocket for their care expenses before Medicaid starts to pay. 

    • The Spousal Impoverishment program can protect the income and assets of the spouse of the Medicaid beneficiary 



  • Individuals can apply for Medicaid at any time they meet the eligibility requirements.

  • Coverage is usually effective from the date of the application submission, not the approval.


Estate Recovery

Under certain conditions, Medicaid will recover long-term care costs paid on behalf of a Medicaid beneficiary. More information can be found at Medicaid estate recovery and Can Medicaid Take My Home?

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