Medicaid Disability Law

Medicaid is a federally funded health insurance program, specifically for low-income families.  Based on eligibility requirements that vary per state, you are entitled to health insurance that you couldn’t otherwise pay for out of your own pocket.  The federal government allows for states to have the freedom to come up with their own rules regarding eligibility, rates, services, and programs.

Under Medicaid, the law allows you to avoid financial ruin, as the cost of long-term care and medical care may be very difficult for your family to keep up with.  However, you must also be aware of the rights that you have in order to better protect your family, and your loved ones.  If you are in a financial bind right now, and are looking towards finding out whether Medicaid can help you with the costs that you are shouldering, then it is best to consult with an elder law attorney familiar with Medicaid eligibility rules before you even start applying for Medicaid.

In general, for you to qualify for Medicaid’s long-term custodial care, you will need to make sure that you are eligible for two foremost criteria: your age and your financial status.  First, your age must be over and above 65, or disabled.  “Disabled” as defined by the Social Security Act, is the “inability to engage in any substantial activity by reason of any medically determinable physical or mental impairment which can be expected to result in death, or has lasted/ can be expected to last for a continuous period of not less than 12 months.”  Second, you must have less than $2,000 in countable resources.  Should you be deemed eligible, Medicaid will be responsible for the cost of long-term care in a nursing home.  Medicaid would also be responsible for paying a third party for providing services to the individual as well.  As an alternative, if Medicaid determines that the cost of nursing home care is going to be more expensive than the patient remaining at home, then you may qualify for a Medicaid Waiver instead.

You must be medically eligible to do this.  The covered individuals are again, aged over 65, and/ or must be disabled.  In this statement, disabled may mean that the intended insured cannot perform the daily routine activities that one may perform himself, such as bathing, eating, dressing up, etc.  In addition to medical eligibility, you must also be financially eligible for the program.  If the disabled person’s income is less than the rate of the nursing facility he is qualified for, then he is financially qualified for the program.  The application process differs from state to state, so it is best to consult your state’s Medicaid website for the needed requirements.


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