group home for elderly

Serving Illinois and Wisconsin

When family members can no longer commit to caring for their elderly parents, they encourage them to consider Lake County Senior Living. Even though we would like our parents to enjoy the remaining years of their lives in the comforts of their homes, sadly, living alone can compromise their health, safety, and well-being.  

Comfort is a priority, but if you compare it to safety, the latter is more pressing. Senior living is a type of community that aims to help seniors live independently while receiving care whenever it’s needed. Some of the examples of assistance they receive are activities of daily living like bathing, dressing, eating, walking, household chores, laundry, etc.  

While many senior living communities offer flexible payment options, you can’t deny that the services they charge will cost you money. Many seniors find it difficult to afford such services. Luckily, Medicaid programs are available and can help seniors with their finances.  

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Medicaid and Medicaid Spend Down

What Is Medicaid?

The services offered by assisted living communities are not for free, but it also doesn’t mean you’ll have to pay for all of them. One way of paying for assisted living services is through Medicaid. Medicaid is a public health insurance program administered by your local state. It was designed to help provide health care coverage to low-income families.  

Does Medicaid Pay for Assisted Living?  

Medicaid can cover some of the costs of assisted living like Alzheimer’s or memory care under one condition; the person applying for it must be eligible. Certain requirements must be met for the elderly to qualify and enjoy the benefits of the program.  

Be sure to check the state since the requirements vary based on where the applicant resides. Room and board are not covered by Medicaid, but emergency responses and skilled nursing are.  

How Much Does Medicaid Contribute to Senior Living?

The following factors influence how much Medicaid will pay:

  • The state of residence
  • The level of care needed

Typically, Medicaid will request a needs assessment to calculate how many hours the program covers. For instance, seniors who require extensive assistance will use more caregiver hours in a month.  

residents of Lake County Senior Living

How Do You Qualify for Medicaid?

As mentioned, the criteria vary depending on the location of the applicant. However, the program has established general requirements such as the following:

  • Must spend almost all assets toward health care
  • Low-income earners  
  • Medical care that exceeds the income
  • Currently resides in a state that offers such benefits

What If You Don’t Qualify?

If your loved one does not qualify for Medicaid because their assets and income exceed the limit, you can do a Medicaid spend down. A Medicaid spend down is a financial strategy and an important tool that you can take advantage of if your loved ones’ income is too high for the limit set by Medicaid.  

Medicaid spend down can be confusing because of its complex web of rules and restrictions. It’s crucial to gain deep knowledge about this tool so you can use it to your benefit.    

What Is A Medicaid Spend Down?

A Medicaid spend down can have different meanings for different states because each state has its own guidelines. Nevertheless, it is considered a financial tactic that you can use when the person’s income surpasses the limit of the Medicaid program. To be accepted, individuals must spend some of their income so that they can finally qualify for the program.  

What Are The Rules and Limits of a Medicaid Spend Down?

The first step is to complete an income or asset spend down. What does this mean? The person’s income must be spent on medical-related bills or health care. They may also spend their income on credit card balances, mortgages, vehicles, and other accrued debt.  

Some examples of the cost that are included in Medicaid spend down are the following:  

  • Past and current medical bills
  • Transportation expenses to access health care
  • Home improvement related to medical care
  • Medical expenses like hearing aid, contact lenses, or eyeglasses

What’s the Difference Between an Income Spend Down Versus Asset Spend Down?

How Does an Income Spend Down Work?

An example of an income spend down is when your father makes $800 every month because of a Social Security check. What if the Medicaid income limit is only $600? In such a case, your father must spend down $200 so that Medicaid will cover nursing costs. This strategy can be challenging as it depends on your father’s medical expenses.    

Assuming your father has a medical bill debt of thousands of dollars. He can pay his medical bills off with the $200 every month. This expenditure is acknowledged by Medicaid spend down. Besides hospital debt, he can also use the excess $200 to cover routine doctor visits and maintenance medications.    

How Does An Asset Spend Down Work?

The asset limit for each state varies significantly for a person to qualify for Medicaid benefits. The individual must spend down all of their eligible assets to be able to enjoy the benefits. However, this does not mean they must sell their property or car.  

What, then, is regarded as a countable asset? An example of a countable asset is when the person has money in their savings account or if that person has a second property that they’ve decided to rent out. Other examples of countable assets are bonds, stocks, and mutual funds.

How Do You Do Medicaid Calculations?

Not everyone has the same financial status. To know the exact calculations, we recommend you consult with a professional Medicaid planner. According to the American Council on Aging, some offer free consultations while others charge a professional fee between $300 and $600 every hour.  

Lake County Senior Living advisor

Get Help From Lake County Senior Living Advisors

If you are considering taking your loved ones to a senior living community in Illinois or Wisconsin, you found us! At Senior Living Experts, we are dedicated to helping your beloved senior loved ones understand the options available so they can live the best life possible.  

Our staff includes financial planners, elder law attorneys, insurance experts, and home health providers ready to provide you with all the help you need. For questions, don’t hesitate to get in touch with our experts. Let us know if you need anything, and we will assist you. Our friendly team will gladly answer your questions and redirect you to the right people when needed.  

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