Long-term care is expensive. According to a recent report from the AARP, the median cost for a private room in a nursing home in the United States now exceeds $100,000 per year. While home health care can often be less expensive than that, paying for any type of long-term care can still put a tremendous financial strain on a family.

Fortunately, there are some options available. You or your loved one may qualify for home health care services. Medicaid is the primary government program that provides nursing home care coverage and home health care coverage to medically-needed children and elderly people. Here, our home health care professionals highlight the most important things that you need to know about how Medicaid pays for assisted living services.

Medicaid and Nursing Care: Understanding the Eligibility Standards

As a starting point, an applicant must qualify for Medicaid coverage. Not all people who are seeking nursing home care or home health care will qualify for care through Medicaid. That being said, many people do qualify. The most recent data suggests that approximately 60 percent of nursing home residents in Pennsylvania use Medicaid to pay for some or all of their costs. To get nursing home coverage through Medicaid, you must satisfy the following two requirements:

  • Medical Eligibility: To receive coverage, a patient must meet the medical eligibility standards. While most people who receive nursing home care coverage through Medicaid are elderly, that is certainly not always the case. Eligibility is based on medical need, not age.
  • Financial Eligibility: Medicaid is a needs-based program. To qualify for nursing home care coverage through Medicaid, a patient must also meet the income limits and the resource limits. If a patient has too much anticipated income, it will prevent them from obtaining Medicaid coverage for their nursing home. Similarly, if a patient has too many assets, they will not be eligible for assisted living coverage through Medicaid until they have “spent down” their personal financial resources.

The Amount Medicaid Pays Will Vary Based On Your Specific Situation

If you or your loved one qualifies for nursing home care through Medicaid, it is possible that the entire cost of the nursing home will be covered by the program. However, there are also some circumstances in which Medicaid will only cover certain health care services, or may require some level of cost sharing by the patient. It is also important to remember that a patient may have to surrender their  income to the state to qualify for Medicaid coverage.

Ask Questions About Home Nursing Care in Phoenixville Today

At Personal Health Care, we are committed to providing exceptional home health care services to children and adults. If you have questions about Medicaid and nursing home care coverage, we can help you get answers or put you in touch with someone who can. To schedule a free in-home health care assessment, please do not hesitate to call us today at (610) 490-8451. Based in Phoenixville, we serve communities all over Southeastern Pennsylvania.