What is Medicaid?
Medicaid is a federally mandated medical benefit program funded in partnership with each state. The
rules can vary from state to state. The respective states administer their program on behalf of that “partnership”. In Texas, the
Health and Human Services Commission is the managing agency.
Why Medicare Doesn't Pay Long Term Nursing Home Costs
Medicare only pays for skilled care, only for a limited period of time and only after a 3-day hospital stay. Medicare will not pay for
treatment for all diseases or conditions. For example, Alzheimer’s, Parkinson’s or a stroke may cause a long-term stay in a nursing home.
The patient receives medical care there. The government considers most nursing home care to be custodial stays. And Medicare does not
pay for custodial nursing home stays.
When Medicare stops paying the bill in a nursing home, families have two choices: pay privately (using long term care insurance or their own
funds) or seek Medicaid assistance. Medicaid offers the only public program that covers long term nursing home care. Once a patient
has qualified, the program can pay a substantial portion of the nursing home bill (often 100%) as well as medications.
Will you be trapped by high nursing home costs?
Life expectancies are lengthening. Long term care costs continue to
rise. Depending on the study you believe, the average stay in a nursing home lasts from 29 to 36 months. Many people cannot afford to
pay $4,500 per month or more for the cost of a nursing home for even a few months. In fact, the Federal government has found the average
married couple is financially ruined in about 12 months!
Fortunately, the Medicaid program is there to help families trapped by high long-term care costs. But the government imposes income and
asset tests a patient must pass to become eligible for benefits.
Four simple reasons legal advice is so important.
- Too many families unnecessarily spend down far more than they are legally required to spend. The law allows you to limit the amount you
need to spend become financially eligible for help.
- The Health and Human Services Commission does not do financial planning for families. They only approve or deny the application for
benefits. It’s up to your family to handle it's own financial affairs.
- Families need to provide enough assets for the security of their loved one. The expenses for one spouse don’t stop when the other
spouse enters a nursing home. And what if the “healthier” spouse has a similar crisis?
- The rules are extremely complicated and confusing. Without planning and advice, you could jeopardize their family security.
Free Consultation
We offer a free initial consultation with an experienced attorney to qualified families in need. If you have a loved one who needs long
term care and want to protect a lifetime of savings, call 713-721-5657.
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