Senior Living Services: Medicaid Assistance
Eugene - Springfield, Oregon
Medicaid: Free vs. Fee Services
Typically my services are free for my clients, as the finder’s fee is paid by the senior community of choice, unless the recipient is receiving Medicaid (not to be confused with Medicare).
Federal law prohibits any senior referral agency from collecting a finder's fee from a care facility when the client is on Medicaid and receiving financial support from the government.
Affordable Care Assessment for Medicaid Recipients
I provide my services at a nominal rate to be paid by the family of the Medicaid client, which includes an in-depth in-person health assessment with a short list of appropriate care facilities that match the client's care needs and personal preferences, guidelines for touring the facilities, and before and after-the-move checklists.
The assessment covers the following functions:
- cognition / behavior
- dressing / grooming
- bathing /personal hygiene
- meal preparation
To qualify for Medicaid assistance for long term care facility payments, you must meet both financial and care needs qualifications:
- Monthly income of $2205 or less (updated 2017) and $2000 or less in savings and assets.
- Care needs should be determined through an assessment conducted by an eligibility advisor.
Questions Regarding Medicaid
Why should I apply for Medicaid?
Monthly payments at a care facility can be anywhere from $3,000 to $5,500 a month, depending upon the type of facility you need. If you have care needs but don't have the financial ability to pay the monthly payment out of your pocket (private pay), you should apply for Medicaid.
Is there any disadvantage to being on Medicaid?
If I am on Medicaid, would I be able to find a care facility to move into?
Yes. There are care facilities, mostly Adult Foster Homes (AFH), that admit new residents who are already on Medicaid. However, many care facilities want a new resident to have enough money to pay the private pay rate for one year before transitioning into Medicaid.
What is the difference between 'private pay' and Medicaid pay?
Private pay is the full amount that a care facility charges the resident for room and board, and care services. Medicaid reimburses the facility at a lower rate. The Medicaid recipient will pay a small portion of that amount based upon their income.
What is 'spend down'?
Spend down means spending down your finances until you are left with the minimum amount of savings allowed that would qualify you to receive Medicaid services. A care facility that has a Medicaid contract may be referred to as a spend down facility. That means it is a facility that would accept new residents with limited private pay ability (preferred; at least one year) and would continue to provide the same services once you are certified through Medicaid.
If I have too much money to qualify for Medicaid, should I 'spend down' or shelter my money in order to qualify for Medicaid before moving from home?
It is important to know that you cannot “shelter” your money by giving it away as the state will look at your finances for the past 5 years. An Elder Law attorney can advise you on legal ways to 'spend down' or shelter your money.
However, it is also important is to understand that if you have the money to pay the private pay fee for a year (or more), it could be wise use that money and time to find an optimal care facility.
Once you are on Medicaid, your options to find a care facility are extremely limited. Whereas, if you are already an established resident transitioning to Medicaid, you would not be moved out by the care community as long as you continue to qualify for Medicaid.