Demystifying Medicaid: What do the different programs cover?

With the current public health crisis, long-term care is more front-of-mind for the average American than it ever has been before. Is long-term care currently part of your estate plan? Have you considered what your preference is for receiving treatments for a potentially chronic or life-threatening illness? Where do you want to spend your final days, when you require extra physical and medical support?

For many, Medicaid is a somewhat mysterious program. You may know it’s available to some people and that there are multiple facets of the program. But what exactly are those facets? What is available for Georgians to consider?

Let’s take a look.

You have three primary options:

  • Hospice: The first component of the Long-Term Services and Supports program provides palliative care (comfort care) to patients with terminal illnesses in both home and inpatient environments. This service includes different levels, including routine home care, continuous home care, inpatient resident care and general inpatient care.
  • Nursing home: The second component of the Long-Term Services and Supports program is for Medicaid-qualified nursing home facility care. Sometimes, a long-term care facility becomes the best and only option—this is especially true in cases of cognitive decline, like Alzheimer’s disease. Medicaid facilitates this option for families who may not otherwise be able to finance this treatment plan.
  • Home care: Through a Medicaid waiver program called the community care services program, some individuals may also qualify to convalesce at home and receive private medical treatment from an in-home or hospice nurse, supplemented by care from friends and family. This waiver program is for frail and elderly individuals who already qualify for nursing home-level care.

Like any government program, there are specific requirements for Medicaid, including—notably—income and resource limits. Waiver programs, like the community care services program, may have additional qualifying terms.

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Kevin Tharpe

With 25 years of experience, Kevin understands how estate planning, special needs planning, and government benefits programs work together. This is a crucial element of a thorough plan. He explains your eligibility for benefits programs and ensures that you do not make costly mistakes that may disqualify you or deplete your assets.

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