18 Jul 0
While Medicare helps with much of one’s healthcare costs, it doesn’t cover everything. A vast number of elderly rely on Medicaid in order to cover those extra healthcare costs during their retirement years. A major exclusion from Medicare coverage is long-term care, such as a nursing home. Medicare does not cover all room and board costs. This comes as a surprise for many, not in the industry and can lead to depletion of their retirement nest egg. Navigating different Medicaid programs and corresponding eligibility criteria is an intimidating task.
What Is Medicaid?
Medicaid is a healthcare program, particularly designed for low-income groups. Although it is primarily funded by the federal government, some states may supplement financing and control of the program. Benefits and eligibility can vary from state to state due to this.
If you are thinking you may need Medicaid please reach out. As an Elder Law Attorney, I have practiced within the scope of Wisconsin Medicaid Law for many years. I can discuss the common Medicaid programs along with the eligibility requirements for those programs in Wisconsin.
Medicaid for the Aged and Disabled
Wisconsin residents who are qualified for SSI (Supplemental Security Income) are inevitably qualified for Medicaid coverage by the Social Security Administration. There is no need to file a separate application until nursing home services actually require it.
The Medicaid program for elderly people falls into two categories:
Medicaid programs which have full benefits involve:
- Medicaid for aged and disabled people
- Home Community-Based Services Waiver Programs
- Institutional Care Program
Medicaid programs which have partial benefits involve:
- Medicare cost-sharing programs
- Medically Needy
- Special low-income Medicare Beneficiary
- Qualifying Individuals
In order to qualify for Medicaid programs for the disabled or aged, you must meet the following requirements:
Age, Blind or Disabled
A person must be 65 years of age or older unless you qualify as disabled.
Note: Disability protects people who are not working and expected to live for a period not less than a year, or expected to result in death.
People who receive a disability check from SSA (Social Security Administration) based upon their personal disability inevitably meet this requirement. A disability determination is finalized by the state DDD (Division of Disability Determinations) or SSA. The Medicaid application is received when DCF submits a request for DDD.
A person must be a citizen of the US or a qualified non-citizen. There might be a waiting period for non-citizens admitted to the US with a qualified status on or after August 22, 1996.
A person must provide proof of identity. Exceptions: People receiving Medicare, SSI or Social Security Disability based upon their personal work history.
A person should be a citizen of Wisconsin.
Social Security Number
A person must have a social security number. If a person doesn’t have this number, then he or she should apply for one.
File for Other Benefits
A person must apply for the other benefits for which they might be qualified. For example, retirement, pension, disability benefits, etc. In addition to the general eligibility requirements, every Medicaid program has asset and income limits which an applicant cannot exceed. Also, this limit completely depends upon the program.
The Significance of Medicaid Planning
All of the Medicaid programs have asset limits. Without proper planning, many will find their non-exempt assets exceed the program limits. Thus causing more money to be spent down prior to the Medicaid application. An important part of estate planning includes covering the costs of long-term care options.
If you have any concerns or questions regarding Medicaid planning, Call us today at 262-812-6262 to arrange a complimentary meeting.