MEDICAID – New York
Medicaid Home Care Seminars
Offered by CaringKind: “Caregivers are guided through the application process for Medicaid home care service in NYC for the person with dementia.” http://www.caringkindnyc.org/medicaidhomecare/ or (646) 744-2900.
Note: Prior attendance at their Legal & Financial Seminar is required: 646-248-2900
MEDICAID AT HOME – also known as COMMUNITY MEDICAID
COMMUNITY MEDICAID (MEDICAID AT HOME) can be used for home care and in Assisted Living Facilities. The following requirements are the same for both Medicaid at home or in a nursing home EXCEPT: The financial look-back period is 6 months for Medicaid at Home instead of 5 years for a nursing home.
NURSING HOME MEDICAID – Long term care
Social security card
Birth Certificate (Proof of Citizenship)
Spouse’s Death Certificate
Military Discharge Papers
Health Insurance Card, Premium and Proof of payment
Current lease, deed, mortgage payment (Any proof of rent or real estate)
Current utility bill in applicant name
2 Letters of residency (Not a relative or landlord – include address and relationship)
Life Insurance Policies
Copy of net and gross income (Social security letter, pension, pay stub)
Income tax returns/1099’s & W-2’s (Last five years)
All bank account statements for the past 60 months (open and closed – all pages) – Explanation of all transactions over $2000
Stocks and Bonds, IRA’s, Annuity’s etc.
Power of Attorney
Income and Asset requirements for Medicaid 2016
Cannot have more than $14,250 in resources
Cannot own property in the community
All income will be due the facility, less $50 a month
Resources in the community cannot exceed $119,220
All combined income over $2,980.50 will be due the facility
**Important information regarding the above:
This is for nursing home medicaid. Community medicaid requirements are the same EXCEPT look back period is 6 months instead of 5 years.
Hours of care will be approved by a Department of Social Services’ nurse and will be determined on an individual basis and need.
Veteran benefits (see also VETERANS under CAREGIVING & SUPPORT) – For those individuals or their spouses who served in the military – VET benefits can apply to Assisted Living Facilities and Nursing Homes. These benefits average around $1000 per month.
Difference between Assisted Living Facility and Nursing Home
The major difference between an Assisted Living Facility (ALF) and a Nursing Home is the amount of care provided. An individual looking to move into an ALF will be evaluated by the staff to determine eligibility. Most ALFs require an individual to ambulate independently (walkers and canes ok – no wheelchairs).
Most ALFs do not accept Medicaid. There are some that do and they can be as nice as the others. Since ALF’s are considered living in the community, only community Medicaid is required. This is important because the look-back period is only 6 months.
Another important consideration: LBD is a progressive illness. Therefore, there will most likely become a point where an ALF will not be able to provide the care needed.
Medicare home health information can be found here: https://www.medicare.gov/coverage/home-health-services.html
Upon discharge from a hospital or rehab facility a CHAA agency (Certified Home Health Aide agency) will be assigned and paid for by Medicare. The CHAA will provide an aide, PT, OT and Social Work services. The amount of services is determined by the CHHA agency. Typically, a bath aide will be provided who will come a few hours a day.