Medicaid is a federal/state program typically administered by each state's welfare agency.
Eligibility: Eligibility and benefits vary from state to state. If the person with dementia is eligible for Supplemental Security Income (SSI), he or she usually is automatically eligible for Medicaid. Those not on SSI must have limited income and assets. The amount is determined by each state. When determining income and asset levels for individuals who live in a nursing home, there are also specific guidelines to protect spouses who live in the community from impoverishment.
Special considerations: The person with dementia should be very careful about giving away assets to family members to qualify for Medicaid. Strict laws govern this area. Check with your legal adviser to be sure you are fully aware of the legal and financial results of transferring property and wealth.
Medicaid and long-term care: Most people with Alzheimer's disease or other dementias will eventually need long-term care services and many will require nursing home care. For people who meet eligibility requirements, Medicaid covers all or a portion of nursing home costs. Be aware that not all nursing homes accept Medicaid. Most states have home- and community-care options for people who qualify, which allow individuals to live in their homes in the community and receive long-term care services.
How to apply for Medicaid: For an application, contact your local Department of Welfare or Department of Health. Medicaid is based on financial need. So, you will be asked to supply information, including:
- where you live
- family members
- your monthly income
- medical expenses
Most nursing homes that accept Medicaid will have staff who can assist you in applying.
Go to Medicaid's website for more information.
Cash and Counseling Programs
Some states have programs for seniors with limited resources and assets, which — rather than going through a home health care agency — allow seniors (or their representative) to pay a person of their choosing, including family members, for in-home services. Such programs are often called "participant-directed services" or "cash and counseling," although similar services go by different names depending on location. Most cash assistance programs are administered by state Medicaid agencies.
To learn if a cash assistance program for home-health services exists in your state, contact your local Area Agency on Aging through its website or The Eldercare Locator (800.677.1116 | www.eldercare.gov)