Can Senior Citizens Get Medicaid?

David Bolton

/

March 3, 2022

General Retirement
Can Senior Citizens Get Medicaid? | Retire Fearless

Millions of Americans benefit from the health coverage provided by Medicaid, but can seniors get Medicaid too?

Medical expenses are one of the biggest challenges for senior citizens. Usually, their pension isn’t enough to pay for premium health insurance, which is why a great percentage of seniors fail to get the medical attention they need.

Senior citizens can get Medicaid through the program Medicaid for the Elderly and People with Disabilities (MEPD). From regular check-ups to hospital care to nursing home care, everything’s covered for senior citizens who qualify for Medicaid.

A common misconception about Medicaid is that the financial aid is limited to long-term healthcare services like the cost of home care and nursing home care. However, senior citizens eligible for Medicaid assistance can also get help paying short-term healthcare expenses. The program has been designed to help elderly and low-income citizens get the medical help they need without worrying about their finances. Quality healthcare is everyone’s right, and Medicaid ensures nobody is left deprived of it.

We have extensive experience working in the Medicaid program since it launched. Using this vast knowledge and experience, we’re going to tell you all about Medicaid options available to senior citizens.

Can Senior Citizens Get Medicaid?
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What Is the Medicaid Program?

Medicaid is a program that aims to provide funding to low-income adults, pregnant women, children elderly, and individuals with disabilities that don’t have enough resources to seek medical help. Medicaid is a combined effort of the State and Federal governments to make life easier for people who struggle with their medical expenses. Those eligible for Medicaid don’t have to pay anything from the medical expenses that the program covers. Sometimes, however, patients might have to make a small co-payment.

Who Can Apply for Medicaid?

Medicaid is a medical assistance program that provides assistance to not just the elderly but to other deserving, low-income families and individuals. Here, it is helpful to know who can apply for Medicaid.

  • Senior citizens – people who are 65 years of age or older
  • People who’ve got a mental or physical disability for more than a year or a disability that will last longer, making the individual unfit for any sort of employment that would help them pay their medical bills.
  • Pregnant women (either single or married). In this case, both the mother and child will be covered by the Medicaid program.
  • Parents of children aged 18 years or younger who need medical attention but are unable to receive it due to a lack of sufficient funds. Parents of children who need nursing home care can also apply for medical assistance under Medicaid.
  • Children up to 21 years of age who are on their own. They can apply themselves or have an adult do it on their behalf.
  • People with low income.
  • People who are either blind or are suffering from a terminal illness who can’t work to pay their medical bills.

What Does Medicaid for Senior Citizens Cover?

Now that you know that senior citizens can get Medicaid, you would naturally want to know what Medicaid covers for senior citizens. As we said earlier, it can cover short-term and long-term healthcare expenses if you qualify for the program.

About two-thirds of the total Medicaid spending goes into providing financial assistance to senior citizens and people who have any form of disability that stops them from working to pay their bills. Medicaid covers the cost of short and long-term healthcare and also covers the cost of community and institutional services and support.

Short-Term Healthcare Expenses

The following is the list of the short-term medical expenses that Medicaid covers for the elderly and people with disabilities under the MEPD program:

  • Cost of medicines and vaccines
  • Regular doctor check-up costs
  • Cost of hospital services and hospital care
  • Cost of lab tests and x-rays
  • Cost of hearing and vision care
  • Cost of treatment of pre-existing health conditions and special health needs
  • Cost of mental healthcare and medical specialists

In short, most of the medical expenses that an elderly patient might have to pay out of their pocket are covered under the MEPD program, provided that you’re able to provide all the relevant documented proof.

Long-Term Healthcare Expenses

While most people manage to pay for short-term medical attention from their pension and old-age benefits, long-term healthcare is often not easy to afford, which is where Medicaid for senior citizens can really make a massive difference. The long-term expenses that the program covers include:

Personal and home care. The program pays the fee of a healthcare professional who helps the elderly with their day-to-day activities and monitors their health round the clock.

The program pays for a caretaker who can take your children to their scheduled medical appointments if you can’t do it yourself due to an illness.

  • Cost for nursing home care.
  • Hospital expenses for mental illness.
  • Cost of a healthcare facility for people who are suffering from intellectual disabilities.

Eligibility Criteria for Medicaid

Not everyone can get help paying for their healthcare expenses through Medicaid. Only those who are eligible can apply. The State will determine whether the applicants qualify or not, based on their evaluation.

Financial Eligibility

Only those who don’t have the finances to support their medical treatment can get aid through Medicaid. For everyone, except senior citizens, financial eligibility is evaluated on the basis of MAGI (Modified Adjusted Gross Income). Parents applying for their children, pregnant women, children applying for themselves, and adults are evaluated for financial eligibility on this basis.

This methodology takes into consideration the taxable income of the applicant and their tax filing relationship. However, in the case of senior citizens, MAGI doesn’t apply since they aren’t employed to receive an income. The financial eligibility of elderly aged 65 years or more, individuals who are blind, and those who’ve got a disability is determined through the SSI methodology.

Non-Financial Eligibility

Finances aren’t the only factors that would determine whether you qualify for Medicaid or not. There is a non-financial eligibility criteria. Senior citizens who are applying for Medicaid should be residents of the United States. Qualified non-citizens, including lawful permanent residents, are also eligible to get Medicaid.

Duration of Medicaid Coverage

Your coverage duration begins after you qualify for Medicaid. The coverage may begin from the date you applied for Medicaid or from the first day of the application month. In some cases, you can have your medical costs covered from 3 months prior to your application, provided that you were eligible during that period.

Benefits of Medicaid for Senior Citizens

Senior citizens can benefit from Medicaid tremendously. Some of the benefits of Medicaid for senior citizens include:

Skilled Nursing and Nursing Homes

In case your health requires you to stay at a nursing home where you can get skilled nursing services, Medicaid will pay for it, provided that you’re enrolling yourself in a facility that has been certified by Medicaid.

Assisted Living

If you’re sick and require someone to be with you at all times, Medicaid has got you covered. Medicaid covers the cost of assisted living for senior citizens.

Adult Day Care

Medicaid also covers the cost of adult daycare. In some states, Medicaid also covers the cost of adult day health care.

Home Health Care

If you need someone to take care of you at home, Medicaid covers home and personal health care too. Not all senior citizens have a family to look after them, and if you’re someone who’s ill and can’t take care of yourself or afford to hire a professional caretaker, you can apply for medical assistance through Medicaid.

About THE AUTHOR

David Bolton

With multiple family members currently in senior living facilities, David is in the trenches every week, learning the ins and outs of nursing homes, assisted living, memory care, and general senior living.

Read more about David Bolton

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