What is Medicaid?

A state-funded program that helps individuals pay for medical costs such as doctor’s care, hospital stays, medications and skilled nursing facility care. You may be eligible for Medicaid benefits if you meet the eligibility requirements, which varies by state.

Individuals are currently allowed to have cash reserves or other assets totaling a set maximum set by the state-specific program, and excludes a non-revocable prepaid burial contract, subject to limitations set by the Medicaid Program Office. If you have a spouse living at home, he or she may be able to keep a portion of your income and your savings to meet his or her living expenses and needs. Further, your spouse can request an assessment to determine the extent of non-exempt resources at the time of admission.

A representative from the Department for Medicaid Services can review your financial information to determine and/or explain the eligibility for enrolling in the Medicaid benefit program. The date you qualify for benefits can also be determined. An application must be made. If you are unable to submit this application on your own, a family member, legal representative or another person who knows about your circumstances may assist you.

The facility, if certified by the state Medicaid program, cannot refuse to admit you, nor may the facility discharge you solely because you receive Medicaid to help pay for the cost of your care. Please let the Business Office Manager know if you have applied for Medicaid or if you decide to apply at a later date. Once your Medicaid application has been approved, the facility will review your past statements to refund any overpayments made during the approval process.

There are some supplies and services that are not covered. Please contact the Business Office Manager or the Social Services department for the most current information. The below are examples of some items and services that may not be covered:

Barber/Beautician services (those services not routinely covered by facility staff)
Flowers and plants
Newspapers and other reading materials
Physical, Occupational & Speech Therapy Services (unless part of a physician-ordered program, meeting certain regulatory requirements)
Personal clothing and comfort items (including smoking materials, if not prohibited)
Private room, unless deemed medically necessary
Privately hired nurses, nursing assistants, or sitters
Telephone service
Cable/Satellite service
Transportation by ambulance to a physician’s office (unless part of your plan of care under the Medicare Program)

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