20 - Using Medicaid for Nursing Homes and In-Home Care

Episode Summary  

Medicaid is a valuable federal program that primarily applies to nursing home and in-home care. The law is open to some interpretation by individual states, so it’s important to consult professionals you can trust to guide you through the legal and financial complexities of the program.

Jeffrey R. Bellomo, founder of Bellomo & Associates, is a licensed and certified elder law attorney with a master’s degree in taxation and a certificate in estate planning. Jeff is skilled at explaining legal and financial topics in easy-to-understand language, as he does in this discussion of the current state of Medicaid as applied in Pennsylvania. 

Key Takeaways 

02:17 – Medicaid basics

Medicaid is a federal program originating with The Deficit Reduction Act (DRA-2005) and The Omnibus Reconciliation Act (OBRA-1996)

The laws apply primarily to nursing home and long-term care (LTC)

Although based in federal legislation, some aspects of the law can vary by state

04:04 – Pennsylvania has state-specific interpretations of the law

Pennsylvania (PA) offers a Long-Term Care Handbook, which is available online 

Interpretations can vary by county and even by caseworker

The PA Department of Human Services has final say if there is disagreement in how the state and an individual interpret the law  

08:38 – Medicare is not Medicaid  

Medicare does not cover nursing home care and LTC

Under Medicare, an individual admitted to the hospital for more than 3 consecutive midnights, can go into an LTC facility for rehab for up to 100 days

Non-compliant or non-participatory rehab patients could lose LTC funding and be forced into private pay

11:31 – PA Community HealthChoices Waiver

This Medicaid program provides in-home care for people with income less than $2,523/month

It can be difficult to qualify for in-home care if a person has income of more $2,523 per month

An excess income trust (see Achieva Family Trust in Pittsburgh) is a possible option for an individual with monthly income of $2,523 plus $500 

14:22 – In-home and LTC staffing concerns

During Covid-19 pandemic, agencies had difficulty staffing in-home caregivers 

Staffing shortages have lessened, but it’s still difficult in some counties

If staffing is not available for in-home care, a person might need to use an LTC facility

16:34 – Your assets can be protected

The monetary limits discussed above will change in 2023

When a person qualifies for Medicaid in PA, the amount of money they can keep depends upon their income

If an individual dies and has assets (in their name alone) of more than $2,400, the state can recover funds from the estate

Hire a professional for guidance if you know someone in a nursing home or someone who might need LTC within 6-12 months 

Links and Resources Mentioned

Bellomo & Associates workshops, including Medicaid 

https://bellomoassociates.com/workshops/

Pennsylvania (PA) Long-Term Care Handbook

http://services.dpw.state.pa.us/oimpolicymanuals/ltc/Long-Term_Care_Handbook.htm

Achieva Family Trust

https://www.achieva.info/family-trust

For more information, call us at (717) 845-5390.   

Connect with Bellomo & Associates on Social Media

Twitter: https://twitter.com/bellomoassoc 

YouTube:  https://www.youtube.com/user/BellomoAssociates 

Facebook: https://www.facebook.com/bellomoassociates 

Instagram: https://www.instagram.com/bellomoassociates/

LinkedIn: https://www.linkedin.com/in/bellomoandassociates