How to Qualify for Medicaid Long-Term Care for Alzheimer’s Disease
Qualifying for Medicaid Long-Term Care for Alzheimer’s Disease
When someone has Alzheimer’s disease and needs long-term care, Medicaid can be a vital source of financial help. However, qualifying for Medicaid long-term care is not automatic and involves meeting specific rules about income, assets, and medical needs. Here’s a simple guide to understanding how to qualify.
**1. Understand What Medicaid Covers**
Medicaid helps pay for nursing home care and other long-term services that Medicare does not cover after about 100 days. For people with Alzheimer’s who need ongoing assistance with daily activities like bathing, dressing, or eating, Medicaid is often the primary payer[5].
**2. Medical Need: Level of Care Requirement**
To qualify for long-term care through Medicaid, the person must require a nursing facility level of care. This means their health condition—such as moderate to severe Alzheimer’s—requires skilled nursing or supervision that can only be provided in a nursing home or similar setting[3]. Before admission to a Medicaid-funded nursing home, there will be an assessment called Preadmission Screening and Resident Review (PASRR) which checks mental health status and ensures the right level of care is provided[3].
**3. Income Limits**
Each state sets its own income limits for Medicaid eligibility; these limits vary depending on whether the applicant is single or married and what type of coverage they seek (nursing home vs community-based services)[2]. Generally:
– If income exceeds the limit set by your state program, you might still qualify through special pathways like Medically Needy programs.
– Many states allow use of trusts (like Miller Trusts) to help those with higher incomes become eligible.
– When admitted into a nursing home under Medicaid coverage, most income goes toward paying the cost of care except for a small personal needs allowance ($30-$200 per month)[2][5].
**4. Asset Limits**
Medicaid also has strict asset limits — money in savings accounts, property (other than your primary residence), stocks etc., are counted as assets[1][3]. To qualify:
– The total countable assets must fall below your state’s limit.
– If you have more than allowed assets when applying, you may need to “spend down” by paying medical bills or other approved expenses until you meet eligibility criteria.
**5. Spend Down Process**
If your loved one has too many assets initially:
– You can spend down excess funds on allowable expenses such as medical bills or home modifications.
– After spending down enough so that remaining countable assets are below the limit set by your state program, they may become eligible.
**6. Planning Ahead Can Help**
Because rules vary widely between states—and because qualifying can be complex—it often helps to consult professionals who specialize in Medicaid planning[2]. They can assist with strategies like setting up trusts properly without violating look-back periods that examine asset transfers over five years before application.
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In summary: To qualify for Medicaid long-term care if someone has Alzheimer’s disease,
– They must need nursing facility-level care confirmed by assessments,
– Their monthly income must meet state-specific limits (or use special programs/trusts),
– Their countable assets must fall below allowed thresholds,
– And any excess resources may need careful spend-down before applying.
Following these steps carefully increases chances that someone living with Alzheimer’s will get access to essential long-term support paid through Medicaid without exhausting all their savings prematurely[1][2][3][5].
