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Can Medicaid cover elder care expenses?

| May 13, 2020 | Elder Law |

Caring for elderly family members can quickly become an expensive problem for modern families. Elder care can cost up to $8,000 every month, and not every senior can depend on pensions or investments to cover these expenses. How is a low-income family expected to bear this financial burden?

The federal government designed the welfare program Medicaid to address the medical needs of low-income families. So how much can Medicaid provide for elder care?

Qualifications and benefits of Medicaid

Though Medicaid is a federal program, states governments manage eligibility requirements. In all states, income determines Medicaid eligibility. Only U.S. citizens and permanent residents are eligible, but health care providers may waive immigration requirements in emergency cases like pregnancy. An individual must establish residency in a state before applying for its Medicaid program.

Florida establishes Medicaid eligibility based on modified adjusted gross income (MAGI). These values are then compared to the Federal Poverty Level (FPL) and evaluated for eligibility. For example, infants can receive Medicaid coverage if their family makes below 206% of the FPL. Children ages one through five are eligible if the family makes below 140% FPL, and children ages six to 18 get coverage if they make under 133% FPL. Florida remains one of 14 states not to offer Medicaid to low-income adults.

Families can still secure Medicaid coverage for seniors, however. Florida does offer coverage to parents and caretaker adults who make less than 29% FPL. Seniors with estates or pensions that still do not cover health care costs may have to liquidate their estates to meet the eligibility requirements.

If eligible, Medicaid covers inpatient and outpatient hospital services, screening and diagnostic services, laboratory and x-rays, transportation to and from medical care, home health services, and nursing facility services. More benefits may be available for those who need it.

Seek legal counsel for help

Families searching for a way to fund upcoming elder care costs have found success working with an attorney familiar with health care law and public benefits. A lawyer can help navigate dense government paperwork and may locate opportunities for funding within the estate or pension plans.

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