Understanding Medicaid
Medicaid Long-Term Care Benefits
There are three great myths about Medicaid
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Medicaid is only for the poor
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Most nursing homes do not accept Medicaid
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Medicaid will make you "Spend Down" all of your savings and retirement
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1. You don’t have to be poor to receive the benefits of Medicaid.
In fact, you can have hundreds of thousands of dollars in assets and Medicaid will still pay for your care or the care of a spouse in a nursing home, an assisted living residence, or in your own home.
2. Most nursing homes do in fact accept Medicaid.
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Over 90% of the nursing homes in Colorado accept Medicaid.
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Many assisted living communities also accept Medicaid. Some communities may limit the number of beds available to new Medicaid residents.
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If you enter one of these facilities and agree to Privately Pay for your care for a certain number of months, generally anywhere from 3 to 24 months, many assisted living communities are happy to accept you, even though you will be converting to Medicaid in the future.
3. With proper planning, you don’t have to "Spend Down" all of your savings and retirement before you start receiving Medicaid benefits.
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You can set aside and protect the majority of your assets for your family and still qualify for Medicaid.
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If you are married you can preserve 100% of your assets for your healthy spouse and still qualify for Medicaid.
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With proper planning, you can even protect a significant portion, if not all, of the equity in your home for your family.
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Medicaid can pay for all of the cost of care in a Nursing Home, an Assisted Living Residence, or even in your own home.
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You can receive these benefits even if you have substantial savings and retirement assets that you want to protect for your family.
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This is especially important when the average cost of care in a Nursing Home is over $11,000 per month; that is over $100,000 a year and memory care can cost substantially more.
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Are you a Veteran?
Qualifying For Medicaid
There are 5 requirements an individual must meet in order to receive Medicaid benefits that will pay for long-term care:​​
Citizenship Test
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Generally, you must be a U.S. citizen or qualified alien and a resident of Colorado to receive the benefits of Medicaid within the State of Colorado.
Medical Test
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If over 65, you must need assistance with at least two Activities of Daily Living (ADLs). ADLs include needing assistance with bathing, dressing, eating, toileting, transferring (getting out of bed, out of a chair or being able to move across the room) or a need for daily supervision. Such care can be provided in a nursing home, an assisted living facility or by an at home care agency in the person’s own home.
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If under 65, you must be totally and permanently disabled.
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A determination on whether you are health eligible for Medicaid benefits is completed when you submit an application for Medicaid Long-Term care benefits
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Most county health agencies contract with an outside agency to determine if a person is health-eligible for Medicaid Long-Term Care benefits.
Income Test
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Colorado Medicaid eligibility rules limit a Medicaid Applicant’s monthly income to $2,742 (2023).
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Even though there are limits on an Applicant’s income, a Spouse’s income is not limited.
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The rules do however provide a means of qualifying for Medicaid even if an applicant’s income exceeds the Income limit and this is where we can help.
Asset Test
Medicaid divides your assets into two categories:
Exempt Assets and Countable Assets
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Exempt Assets are those assets that will not be counted when determining eligibility for Medicaid.
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Countable Assets are those assets that will be counted when determining whether assets exceed Medicaid benefit asset limitations.
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The applicant's Countable Assets are limited to a total of $2,000.
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A Spouse who is not applying for Medicaid is permitted to retain $148,620 in Countable Assets (2023).
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Medicaid will impose a penalty waiting period if you transferred any property for less than its fair value (gifts) during the last 5 years. Commonly referred to as the “Five-Year Look Back".
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Exempt Assets
Your home provided your equity does not exceed $1,033,000.
Exempt Assets
A car (any make or model)
Exempt Assets
Personal property in and around your home
Exempt Assets
Certain final expense and burial plans
Exempt Assets
Special types of annuities
Countable Assets:
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Cash
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Checking & Savings
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CD's
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Mutual Funds
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Stocks & Bonds
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Real Estate
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Business Assets
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All Other Items of Value