Senior Care and Medicaid


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Senior Care and Medicaid by Jacob Edward

Many people are largely unaware of the fact that Medicaid can help seniors pay for long-term care. Most seniors understand the benefits of Medicare, which can help with temporary situations like skilled nursing for rehabilitation and home health. When it comes to long-term care needs, Medicaid is the program to look towards for those who need help financially to meet their care needs on a long-term basis. Medicaid programs vary state by state, but here are some general rules to follow in exploring whether Medicaid might be an option for you.

In broad strokes, in order to qualify for Medicaid in regards to long-term care, you will need to meet a financial and medical qualification. The medical qualification will determine if you are indeed in need of long-term care. The financial application will determine whether or not you are in need of assistance, as per the standard of your state’s Medicaid program.

So, who qualifies for Medicaid for long-term care? Generally, long-term care is necessary for seniors and other disabled individuals who cannot maintain themselves living independently in their own home. Reasons for this might include memory loss, a lack of mobility, or other issues that prevent a person from living alone. Long-term care is intended to supplement these individuals who need help with the activities of daily living (sometimes called ADLs) such as personal care and hygiene, food preparation, toileting, and other things that we all have to do on a day-to-day basis. Typically, Medicaid patients will receive care at the directed care level in order to qualify for this benefit. Other conditions, such as diagnosed Alzheimer’s Disease may also play a major role in helping a person qualify.

Financial qualifications vary greatly from state to state. We recommend checking with a lawyer or financial adviser from your area if you are not able to get enough information about your local laws regarding financial qualification. It is especially important to do this if you are married, as you may have to make additional arrangements.

The next question is: what kind of care can I get on Medicaid? Medicaid provides for directed care, which means that you will be receiving daily care from professional caregivers. Directed care is usually administered in an assisted living, residential care (group home), or nursing home setting. Certain states may have restrictions as to where you can live if you are accepting state assistance, while others are less restrictive. It is important to find out if any of the places that you are considering accept Medicaid. Those homes that accept Medicaid are usually very accommodating and will help you get all your ducks in a row for your application.

Some people who qualify for Medicaid choose to continue to live on their own. This almost always means another family member is taking care of them in the home full time. In certain states, the Medicaid supplement can be used to bring additional help into the home to supplement the primary caregiver, or to give them a break. This supplement also varies, but may be an option in certain situations.

A word of warning: the long-term care benefits from Medicaid are one of the more complex benefit programs for individuals. If you think that Medicaid might be an option for you, be sure to do all of your research to make sure that you are making the right choices for yourself or your loved one. However, despite how frustrating it can be sometimes, those who need it understand just how absolutely essential this program is.


Jacob Edward is the manager of Senior Planning in Phoenix, Arizona. Jacob founded Senior Planning in 2007 and has helped many Arizona seniors and their families navigate the process of long-term care planning. Senior Planning provides assistance to seniors and the disabled by finding and arranging care services, as well as applying for state and federal benefits. In his spare time, Jacob enjoys dining out and supporting his alma mater, Arizona State’s Sun Devil sports teams. Jacob lives in Tempe, Arizona.

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