The Medicaid system is a complex maze of federal policies and state regulations. This matrix looms larger still when trying to navigate it while in crisis mode. Addressing the declining health of yourself or a loved one is daunting, but much more so while under the burden of the sometimes unbearable weight of long-term care costs. Legacy Senior Solutions (LSS) lifts this load and the accompanying frustration, fear, and worry off your shoulders and places it squarely on ours; allowing your focus to remain on the well being of the individual in need. Having Legacy on your side means you’ll have full assurance that the plan of action set before you meets our strict requirements of maintaining traditional, moral and ethical principals while dutifully adhering to the laws of the land. You can trust that our tried and true processes are trustworthy. We stay current with ever-changing Medicaid rules and qualifications, which we never assume are set in stone and remain vigilant and mindful of new laws and regulatory practices. Our comprehensive review process gives us the stellar advantage of a fully developed application that will minimize processing time. Our job is to free you from the anxiety of uncertainty, helping you to be able to spend your time and attention on the truly important things in life. You can be confident that we have the knowledge, skills, and ability to design a strategy that fits your unique situation and succeeds in securing your long-term care needs. At LSS we take pride in knowing that we have contributed to your and your family’s peace of mind. How did we do that you ask? By bringing a lost art back to customer service, the art of Caring.
MEDICAID PROGRAM INFORMATION
Medicaid (Title 19) is a health care program which is both state and federally funded. There are programs for low-income individuals of all ages. However, the information listed below focuses strictly on Medicaid eligibility for elderly residents who are 65 years of age and older. It will specifically cover Long-Term Care Medicaid in a resident’s home, an Assisted Living Facility, or a Skilled Nursing Facility. Eligibility is approved only if medically necessary on a need-based basis with eligibility criteria differing by state. There are slight differences in the financial and functional eligibility requirements, as well as varying benefits for each program. Eligibility is further complicated by the facts that the criteria varies with marital status and the state offers multiple paths towards eligibility.
The Medicaid Program in Iowa is also referred to as IA Health Link. It is a managed care program. The Iowa Department of Human Services’ (DHS) division of Iowa Medicaid Enterprise administers the Medicaid program.
Medicaid in Nebraska is administered by the Nebraska Department of Health & Human Services (DHHS) agency.
There are several different Medicaid Long-Term Care Programs for which seniors may be eligible. The first two programs include the “Look-Back” period. The third program does not currently have a “Look-Back” period associated with the program and is not subject to penalties.
1) Institutional / Nursing Home Medicaid: This is an entitlement program. This means anyone who meets the eligibility requirements is offered assistance. It is provided only in nursing homes. Client Participation is required for this program.
2) Medicaid Waivers / Home and Community Based Services (HCBS): Waivers limit the number of program participants. There is a waiting list once the enrollment cap has been reached for the year. Services are provided at home, adult day care, or in Assisted Living. Client Participation is required for this program.
3) Medically Needy / Aged Blind and Disabled (ABD) (Spend Down Program): This is an entitlement program. Services are provided as long as an individual meets the eligibility requirements. Assistance is provided at home or adult day care. A Spend Down of gross monthly income is required for this program.
Questions about Medicaid Planning or eligibility?
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