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What Is Medicaid


Medicaid is more comprehensive in its coverage, but the benefits are specific to the age group.  Children have different eligibility requirements and receive different benefits from low-income adults and from elderly or disabled people. Medicaid is state run and has different benefits in every state. Medicaid pays for nursing home care and through waiver programs, pays for home care, personal care and assisted living.  If a senior is financially and medically qualified, Medicaid will pay nearly all of his or her long term care costs. Medicaid is referred to by different names in some states. You can go to the Medicaid website in your state for all the rules and procedures for the program.

You should make sure to be aware of what the program offers and what is necessary to become eligible if needed.  More importantly you need to know about Medicaid BEFORE you need it.

The reason you need to educate yourself about Medicaid before you need it is that there are many rules and requirements regarding your finances and how you spend your money 5 years prior to when you may need to file for Medicaid. This is called the 5 year look back. That is correct, what you spend your money on right now can play actually cost you money when you apply for Medicaid two or three years later.

Five Year Medicaid Look Back

If someone needs nursing home care, the person must meet requirements for limited income and assets to qualify for Medicaid coverage for nursing home costs. Medicaid, a last resort way of paying for nursing home costs, requires that a nursing home resident first use other means of paying for care before Medicaid will provide coverage.

Medicaid will make sure all money and assets are not just transferred to someone in order to avoid using ones own funds when a person has the ability to pay some of the costs associated with nursing care and senior living costs.  Medicaid does this in part by using the five year look back period to determine if there have been any violations regarding asset transferring.

The look back period is when the state agency looks back over the previous five years to see if any of the person's assets were sold for less than true asset value, given away or transferred within the same time period when determining whether they are eligible for Medicaid coverage and any violations that could delay their approval. They do this by requesting that you provide bank statements and a variety of other financial records going back five years from when you file your application.


It is very important to consult with an Elder Law attorney for Medicaid pre-planning, filing and even just to get the most basic and important information if you choose to proceed on your own.

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