Understanding Medicaid: From Nursing Homes to Community Based Services

In the state of Missouri, Medicaid offers several useful programs that can help residents qualify for a variety of health services. Some of these are designed to help specific groups of people, such as pregnant women and those who are blind or disabled. Others are targeted toward elderly members of the population. Among the most helpful of these are Nursing Home Medicaid and Home and Community Based Services, the latter of which provides community services for people who are not in a nursing home. Because of the strict income requirements of these programs, though, qualifying may require some shrewd financial management. Hiring an experienced elder law and Medicaid planning attorney is the best way to make sure you and your family are protected.

Nursing Home Medicaid

If you or a loved one suddenly find yourself in need of an extended stay in a nursing home, you may be faced with unexpected costs that can quickly whittle away your savings. Qualifying for Nursing Home Medicaid is the best way to protect yourself and your assets. To qualify in the state of Missouri, you must meet the following requirements:

• 65 years of age or disabled
• U.S. citizen or legal resident
• Resident of Missouri
• Demonstrated medical need for care
• Assets of less than $5,000 at least one day for each month of the patient’s Medicaid eligibility
• The patient’s income must be less than the cost of care
• The patient’s spouse must have assets worth less than $137,400 at the time of application.

Patient Responsibility

Once you qualify for Medicaid, you will still have to pay for some of your stay at the nursing home. The amount you pay each month is known as “patient responsibility.” Patient responsibility is determined by taking the applicant’s gross income—which includes social security and retirement as well as wages, interest, alimony, and rental income—and subtracting the following deductions:

• The patient’s health insurance premium
• An allowance of $50 per month to pay for any extras not covered by Medicaid
• If the patient is married, an amount to cover the spouse’s needs is determined based on the spouse’s income and the number of their needs.

The amount of the patient’s responsibility can be adjusted any time the patient’s income or financial circumstances change.

Home and Community Based Services

Another program offered in the state of Missouri is the Home and Community Based Services program. This program provides a variety of senior and disability services for those people who wish to remain at home and not enter a nursing home. This program may help the applicant pay for home health services and provide community outreach for the patient.

The Home and Community Based Services program follows most of the same eligibility requirements as Nursing Home Medicaid with the notable exception that the recipient’s income must be less than $1,173 per month. In addition, applicants will receive an assessment by the Department of Health and Senior Services to determine whether they would need skilled care if home health services were not provided. The department’s staff will then decide how many hours a week of service the person qualifies for.

Finding an Experienced Elder Law Attorney

Nursing Home Medicaid and Home and Community Based Services can be a lifesaver for people who suddenly find themselves unable to fully care for themselves. Nonetheless, qualifying for these services and maintaining eligibility can be tricky. For this reason, it is important to retain an experienced elder law and Medicaid planning attorney.

Contact The Law Firm of Christopher W. Dumm

At the Law Firm of Christopher W. Dumm, we have many years of experience helping our clients protect their assets and ensure their family’s well-being. When you need an expert estate planning attorney, give us a call at 417-623-2062 or fill out the contact form below.