Understanding Long-Term Care Medicaid: Everything You Need to Know

Understanding Long-Term Care Medicaid: Everything You Need to Know

When you need Long-term care services whether in a nursing home, assisted living facility, or for home care, this can quickly become financially overwhelming. Medicare does not cover Long Term Care, so many wonder how to manage these expenses. That’s where Long-Term Care Medicaid—a state-funded program designed specifically to cover these costs comes into play. But what is Medicaid and what does it cover? How does one navigate through its complexities? This blog aims to unravel and answer these questions.

What is Long-Term Care Medicaid?

Medicaid is distinct from Medicare. Medicare is a federally funded  benefit that you acquire at the age of 65 from working enough quarters  paying into Social Security or if you are under 65 years of age and become disabled.   Long Term Care Medicaid is a federal and state-funded program available for individuals who have limited income and resources with medical needs. Long-Term Care Medicaid, as the name suggests, provides financial coverage for long-term custodial care.

What Does Florida Long-Term Care Medicaid Cover?

The scope of Florida’s Long-Term Care Medicaid is vast. It covers:

  • Medical Costs: Including co-pays and other related expenses.
  • Nursing Home and Rehabilitation Costs: Room and board for nursing homes or skilled nursing rehabilitation centers are covered above the client’s monthly income. 
  • Assisted Living Costs: Medicaid pays for the Level of Care in the assisted living facilities, typically ranging from $1,200 – $1,500 per month, based on the facility’s contract with Medicaid.
  • Home Health Aide: For those preferring at-home care, Medicaid provides in-home services on average of 20 hours a week, depending on the needs.
  • Adult Day Care Center Costs: For those needing activities and socialization outside of the house, Medicaid offers financial support for adult day care centers.

The Financial Benefit

To provide perspective on the value of Long-Term Care Medicaid:

  • Skilled Nursing Care: Without Medicaid, costs can average around $109,688 per year. Medicaid can cover these costs for eligible individuals.
  • Assisted Living Facilities: These can cost between $3,500 – $6,000 per month out of pocket. However, Medicaid can cover care costs, leaving clients responsible mainly for room and board.
  • Home-Based Services: Private costs can be approximately $25/hour for a Certified Nursing Assistant. Like nursing care and assisted living, Medicaid can cover these costs for any eligible individuals.

The Challenge and Solution

Navigating the Medicaid application process is daunting. Mistakes can be expensive, with potential denials leaving individuals to bear heavy costs. With Long-Term Care housing often exceeding $100,000 annually, a wrong move can be financially disastrous.

This is where professional services, like those at Medicaid & More, come into play. Our specialists expedite your approval process, decrease stress levels, save you money, and ensure your application is accurately filed.

Understanding and navigating Long-Term Care Medicaid is essential for those considering long-term care options. With the right knowledge and assistance, you can make informed decisions, potentially saving thousands of dollars. 

At Medicaid & More, we’re here to guide you every step of the way. Don’t delay; reach out today for a comprehensive consultation.


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