Medicaid Qualification

Medicaid is a government program that assists seniors and people with disabilities who cannot afford their own care. It is managed by the Department of Social and Health Services (DSHS) in this state. It helps single individuals and even married couples when an individual has challenges with their Activities of Daily Living (“ADLs”) such as mobility, grooming, eating, hygiene, dressing, medication management and more.

The qualification for Medicaid includes a financial test and a physical one. The applicant must satisfy both tests to qualify. The financial standards can be found in my Helpful Resources section under Medicaid. The physical test revolves mostly around the ADLs.

The assistance for married couples can be particularly helpful since you can protect some assets (sometimes all) for the well spouse while providing benefits for the spouse who has challenges with his or her ADLs. One of the goals of Medicaid is to not impoverish the well spouse while the marital community uses its assets to protect the disabled spouse.

The assistance DSHS provides can take the form of care in a nursing home, assisted living facility, adult family home and even at home care. It can include medications and more.

Examples of some of the programs that are available include.

  1. Nursing home care.
  2. Copes program for at home care or in assisted living.
  3. Medically Needy Residential Waiver Program.
  4. Medically Needy Nursing Home Waiver Program.
  5. Respite Care for Caregivers.

The DSHS does have a recovery program to recapture the benefits paid out after the disability has been resolved or the recipient passes away. However, many (sometimes all) of a couple’s assets can be protected for the benefit of the surviving spouse but it does require some planning.

Please see my Helpful Resources section for links to more information on Medicaid qualification.

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