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If You’re On Medicaid, Can You Get Into A Nursing Home?


The rules underlying Medicaid, and whether it can be used to get into a nursing home, are complex. Being aware of these rules, and speaking with a Medicaid planning lawyer, makes it easier to understand if you, or someone you know, can get into a nursing home with Medicaid. 

What Is Medicaid? 

Right before we can go over whether or not someone, who relies on Medicaid, can get into a nursing home, it’s important to clarify what Medicaid is.

Within the United States, Medicaid is a program that is financed by both Federal and state governments. The purpose of Medicaid is to ensure that low-income individuals have access to the medical care they need.

Some of the medical services that Medicaid covers are as follows:

  • In-patient hospital services.
  • Out-patient hospital services.
  • Laboratory services.
  • X-Ray services.
  • Physician services.
  • Home health services.

Every single one of these services can be accessed by someone who relies on Medicaid. But, if an individual who relies on Medicaid needs to obtain other services, things can become a little more confusing. 

If You’re On Medicaid, Can You Get Into A Nursing Home? 

The simple answer to this question is “Yes.” But, the reality is rather complicated as, generally speaking, Medicaid will only pay for someone’s nursing home care if they are already in a nursing home.

Given this fact, in order for someone who is on Medicaid to get into a nursing home, they must be able to pay for their time at a nursing home, using their own funds, until they can switch to Medicaid.

To accomplish the above, there are two methods that someone who relies on Medicaid can use. None of these methods are guaranteed to work, but they are always worth considering.

Making Use Of Medicare 

Within the United States, Medicare can be used to pay for up to 100 days of skilled nursing care.

Someone who came out of a hospital stay no more than thirty-days ago can enter a nursing home that treats the condition they were hospitalized for and, within this time, rely on Medicare.

Right after someone enters a nursing home, they can apply for Medicaid. If they are successful, then Medicare will pay for their stay at the nursing home. 

Setting Up A Private Pay System 

Someone can enter a nursing home and, if they have the assets to pay for a few months of care, can pay for the beginning of their care.

Right as their assets continue to dwindle, they can then apply for Medicaid. By doing so, they can then have Medicaid pay for the remainder of their stay at a nursing home.

Some nursing homes do not take Medicaid. For this reason, it’s important to find a nursing home that does take Medicaid and, in turn, to apply for Medicaid before one’s assets run out.

Speak With A Medicaid Planning Lawyer 

If you are on Medicaid, you can get into a nursing home. But doing so isn’t always easy, unless you work with a lawyer.

Speak with a Medicaid planning lawyer at the Millhorn Elder Law Planning Group and we will assist you in using Medicaid, and other government resources, to obtain the care that you need.





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