● Know Your Rights ● Know Your Options
PA Long-Term Care Medicaid Planning, Consulting and Application Services
Advocating for Seniors and Families
PA Long Term Care Medicaid
When it’s time to find long-term care for a loved one there are many important decisions to make. Although safety, health and comfort are the primary focus, there is also the reality of paying for long-term care. LTC Medicaid (MA) can cover this expense, either at home or in an MA provider skilled nursing facility, but only if the applicant qualifies medically and financially.
LTC MA Solutions, LLC provides a complete analysis of all assets and financial history and offers guidance regarding the best asset protection options available within MA regulations to qualify for LTC Medicaid, as well as complete Medicaid application services.
Medicaid Coverage: Nursing Home vs. In-Home Care
Nursing Homes and Medicaid
Medicaid will cover the expense of full time care in a skilled nursing facility that accepts Medicaid, but only if you qualify medically and financially (refer to "Do I qualify?" tab above). The facility may also assist with the Medicaid application process, but they are not responsible for protecting assets or saving the family’s inheritance and they will only suggest minimal options to spend-down (reduce) assets when qualifying for Medicaid (i.e. paying nursing home/medical expenses or opening a burial trust).
There may be other opportunities to protect assets and it's in your best interest to know all of your options.
In-Home Care and Medicaid
Medicaid also covers in-home care, known as the DHS Aging Waiver (a.k.a CHC Waiver), and the qualification factors are similar to nursing home Medicaid with the exception of income. However, the Aging Waiver will only cover a maximum of 8-10 hours per day, which is determined by an assessment completed by the County's Aging Adult Services agency. This agency will also assist with the Medicaid application process, however, they will not provide guidance for protecting assets and will only offer minimal options to spend-down (reduce) assets in an effort to qualify for Medicaid.
There may be other opportunities to protect assets and it's in your best interest to know all of your options.
Medicaid Does Not Cover...
PA Long Term Care Medicaid will not cover the expense of a retirement community, assisted living or personal care units. Although assisted living facilities may be able to accommodate the needs of residents with a higher level of care (medical needs), they are not consider a "skilled nursing" facility and Medicaid will not cover this expense. However, if these types of establishments are located within a Continuing Care Retirement Community (CCRC) and their skilled nursing unit is an MA provider (accepts Medicaid), then Medicaid will cover the expense once the resident is moved to the skilled nursing unit (nursing home) within the CCRC and meets the Medicaid qualification requirements.
Also, not all nursing homes or physicians will accept LTC Medicaid for payment of services. They must first be a state registered "MA provider" prior to receiving funding from the Department of Human Services LTC Medicaid.
Do You Need Representation When Applying for LTC Medicaid?
Determining Your Need for Representation
Information is power and knowing your options to save or protect resources can be the difference between losing everything or securing assets for the spouse or family. It is always in your best interest to know your options and have an advocate on your side, but it is critical when your assets substantially exceed Medicaid's qualifying limit. Refer to the Frequently Asked Questions (F.A.Q.) tab above to find your maximum asset allowance when qualifying for Medicaid.