A Medicaid primer review for you to be able to make better decisions. Let’s review some of the basics of Medicaid coverage for those going into nursing homes or skilled nursing facilities.
Medicaid is our country’s second largest health program in terms of expenditures, only trailing Medicare, but it’s the largest in enrollment. The U.S. Department of Health and Human Services’ 2016 actuarial report found that Medicaid insured 70 million people across the country in 2015.
Medicaid was enacted in 1965 by the same legislation that established Medicare. It’s an entitlement program that provides assistance to all individuals who meet the criteria for eligibility. The beneficiaries include the poor elderly and is a primary source of long-term care coverage in the U.S.
Medicaid is financed through a federal-state partnership, and each state coordinates its own program. The total federal and state Medicaid spending was roughly $532 billion in FY 2015.
Medicaid Primer Review: Who Is Eligible?
Those who qualify for Supplemental Security Income (SSI) automatically qualify for Medicaid in Florida.
Nursing Facility Services: Who is Eligible?
Medicaid provides nursing facility as a setting for care and services from Medicaid-certified nursing homes. These facilities provide three types of services:
- skilled nursing or medical care and related services;
- rehabilitation for injury, disability, or illness; and
- long-term care.
The Medicaid-provided long-term care is health-related care and services that’s above the level of room and board and isn’t available in the community, but required regularly due to a mental or physical condition.
States can’t limit access to the nursing facility services or make it subject to waiting lists, as they can for HCBS (home and community-based services). HCBS provide opportunities for Medicaid beneficiaries to receive services in their own home or community instead of in institutions or other isolated settings.
The need for nursing facility services is defined by the State of Florida, which has created criteria for nursing facilities. State level of care requirements must provide access to individuals who meet the coverage criteria defined by federal law.
If you have questions about Florida Medicaid, Attorney Frazier is a skilled Medicaid planning (with over 2,000 cases completed that helped preserve their family’s savings), estate planning and elder law practitioner. Please contact Attorney Frazier for a free telephone consultation at 727-586-3306 extension 104. If you prefer click here now to send in a contact form and we will call you.