Medicaid Can Help With Long Term Care Costs

By Eileen Doherty, MS ~

Denver, CO  – As families become overwhelmed with providing care for their mother or father, they often find long term care to be expensive and out of their reach. According to Genworth, the monthly cost of homemaker services is about $4900, adult day care is $1600, assisted living is $4000, a semi-private nursing home is $7900, and a private room is $9000.

Many Americans believe that Medicare will pay for long term care. However, Medicare only pays for limited care that is rehabilitative in nature. Medicaid may be able to assist with paying for care, but one must quality for help both functionally and financially.

Functionally, an individual must need help with two of the following: bathing, incontinence, eating (not shopping and cooking), transferring, mobility, and dressing. Individuals may also qualify if they need help with supervision or behavior management. Many times a loved one can qualify for help if they are not following doctor’s orders for taking medications, get lost when driving, or forget to pay bills.

Financially, an individual must make less than $2313 per month in income and have less than $2000 in assets. Couples are allowed to make considerably more. For example, a couple can make $4626 per month in income and have $128,420 in assets, excluding the house, car, irrevocable burial policies, and term life insurance.

If an individual or a couple is over-income, Medicaid may still be able to help if the individual creates a Medicaid Qualifying Trust. The Trust can be created through the use of a pre-approved form from the County Department of Human Services.

Sometimes individuals are reluctant to apply for Medicaid because of fear of a Medicaid Lien. While the state can place a Medicaid lien can on the home in certain circumstances, most of the time, one is not placed on the home. A lien only becomes due when the loved one needing care dies or title to the property is transferred.

The Single Entry Point agency responsible for each county is responsible for conducting the functional interview and intake. The Single Entry Point agency determines if the individual is eligible and approves services. The County Department of Human Services is responsible for reviewing and approving the financial application.

Medicaid can pay for services in the home including Home and Community Based Services, In-Home Support Services, and Consumer Directed Attendant Support Services; adult day care; assisted living, and nursing home care. Sometimes families can be paid to provide care in the home.

For more information about Medicaid, visit www.senioranswers.org or call 303-333-3482 to talk with a counselor.

Eileen Doherty

Eileen Doherty

Eileen Doherty, MS is the Executive Director of the Colorado Gerontological Society.  Her areas of expertise include management and administration of nonprofit organizations, education and training on issues related to older adults, advocacy and policy development on senior issues, and clinical practice in working with seniors and families to manage their lives in the later years. She has been the Director of the Society since 1982.  She teaches Nonprofit Management for Fort Hays State University.  Her phone number is 303-333-3482 or doherty001@att.net.


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