Medicaid Long Term Care Guide
Eligibility by State
Every state has individual programs and eligibility requirements for their Medicaid long term care. Medicaid long term care is a partnership between the state and federal government with the goal of taking care of each state’s aged, blind, or disabled populations. Click your state for a comprehensive look at available programs and eligibility qualifications.
Using the guide
Senior Planning provides a broad state guide for Medicaid long term care programs nationwide. This resource is free and is compiled by Senior Planning employees. Please use the guide and the supplemental resources provided as an assistive tool to determine the kinds of programs and care that might be available to you. Medicaid programs are very detailed and as the scope of this tool is not all encompassing, we recommend that anyone applying seeks help from local experts before taking action based on the information we provide.
We endeavor to keep our guide as comprehensive as possible. If you are seriously considering a Medicaid application, be sure to check to see if there have been any program changes in the state in which you live. If you would like to submit additional information, or a correction to the guide, please contact us directly at [email protected].
Here are some terms that may be helpful to you before reading the guide. Please feel free to submit any terms that are confusing or unclear to [email protected] and we can add them to the glossary.
Blind: Visual acuity of 20/200 or less, or limited visual field of 20 or less, with best correction.
Disabled: Unable to engage in gainful work for at least 12 months as determined by the Social Security Administration or Medical Review team.
Community Spouse: The spouse who does not need long term care services.
CSRA: Community Spouse Resource Amount, or the amount of resources a community spouse is able to keep if their spouse is receiving long term care funding.
Spend Down: Spend down refers to the amount of long-term care related expenses that are a person’s financial responsibility, similar to the deductible of an insurance policy. The amount of the spend down is determined by how much an applicant’s net income exceeds the non-spend down income limit. Income cap states do not allow spend down.
Estate Recovery: The federal government has a policy necessitating that all states must attempt to recover the costs spent on behalf of those who received certain types of Medicaid coverage during their lifetime. All states try to recover long term care costs, including hospitalizations while in long term care or home health services. In addition, some states attempt to require general Medicaid costs for patients who were 55 years or older when they began needing Medicaid. When someone becomes eligible for Medicaid, federal law mandates that the state inform the individual through written documentation of the estate recovery process following the individual’s death.