Medicaid Coverage of Nursing Home Care

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Eligibility for Medicaid nursing home coverage

Medicaid is a federal government program that pays long-term nursing home costs for people with low income and few assets (other than a house they own). Each state administers its own Medicaid program, with slightly different eligibility rules. Note also that Medicaid offers separate coverage for medical care. And in some states, Medicaid pays some of the cost of assisted living for eligible residents in participating facilities.

Medicaid nursing home coverage is available only to people who are unable to care for themselves at home. They must also meet their state's eligibility limits regarding income and assets, which differ depending on whether the resident is single or part of a married couple (see below). They may reside in any level nursing home that's certified by Medicaid and that accepts Medicaid payment. Be aware, however, that some nursing homes only accept Medicaid payment for a limited number of residents.

Unlike Medicare coverage for nursing home care, there's no Medicaid requirement of a prior hospital stay, no restriction to skilled nursing facilities, and no requirement that the person need skilled nursing care or still be recovering from an illness or injury in order for Medicaid to continue coverage. In other words, Medicaid -- unlike Medicare -- will cover residence in a nursing home purely to provide help with the nonmedical activities of daily living -- what's called "custodial care."

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