top of page
  • Writer's picturePam

Why Is The Wait List At Facilities That Take Medicaid So Long?

Have you been thinking about moving you or your loved ones to a senior facility but you keep putting it off? Many families try and keep their parents or loved ones in their home as long as they can which certainly makes sense. However, sometimes that means waiting until the point where there is no other option and then realizing they are low on money. What happens then?

If you need to find senior living for someone who has very little money left you are most likely going to be considering Medicaid. Medicaid and Medicare are two different things. Medicaid is a federal program where you apply for money from the state in which you live to pay for health coverage if you have low income. Medicare is what you get that pays for medical care when you are over 65 or under 65 with a disability. Many facilities use Medicare and Medicaid together to cover costs but what is covered under each is different. If you are looking to move you must first check to see if the place you are considering accepts Medicaid or not. Many facilities DO NOT accept Medicaid so if you can't pay them directly with your own funds you can't live there.

There are some facilities that are private pay but have a few Medicaid beds that are available for people and then there are nursing homes that have many Medicaid options. A Medicaid bed means a facility has a certain number of beds that the state will pay the facility for. If you are on Medicaid then the facility uses your social security or any available insurance or other funds and then the state pays the rest for you. You must ask very detailed information when trying to understand what type of facility will work with your financial situation.

The waiting list for many nursing homes is very long especially for those with very little income and who need Medicaid now. If you have money to pay privately for a while but then eventually will need to apply for Medicaid then the wait in those facilities is much lower. Here is an example below of what happened to me with my mom recently and may help you understand better.

Since I learned a long time ago about the need for private funds I was beginning my search. I found a facility that takes Medicaid and went to take a tour. Decided to apply to see if we were eligible for moving there. We were told that we should have at least a year and a half of private pay money and then if we needed to apply for Medicaid that would be fine and we would be able to stay there on Medicaid. If we did not have enough private pay to cover at least a year or more than the wait list for a Medicaid paying bed was two years. Yes you heard that right, two years. The reason for that is the facilities want money and they want people who can pay them money for a while before they have to take Medicaid. This does not mean that someone without funds can't get a bed but they are not the preferred resident so they wait longer. You will notice that many of the places that have Medicaid beds for people with very little private pay funds will not be as nice as some others. So while there are places you can get into with low funds it is a much more difficult process. Many people do not fully understand the difference between types of facilities and what type of payment is available to them.

What this means for families is that you need to plan ahead. You DO NOT want to wait until you absolutely have no other choice to find a nursing facility if you think you will need one for someone. You will have more options and better transition doing it while you still have private funds. It is not right and very sad that the system works that way but it does. This is something many people have no idea about. It is important to investigate options for loved ones long before you actually need to make the move.

17 views0 comments
bottom of page