littlemisskitty Asked March 2016
How does Medicaid work?
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I'm new to this whole financial asset stuff. I'm moving to Maine in two months. Right now we are in the state of Connecticut and they have lots of help without having my grandma on medicaid. They have a specialist drug program, supplement care and state care which helps to finance. Maine doesn't appear to have any of that. So how does Medicaid work if someone is living with a family. I know it's a good idea in case she gets to the point of where she needs more care than we can give but meanwhile can someone on medicaid still live in the house and pay their bills?
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Medicare is a federally based entitlement. As such, it is totally portable, so if grannie sees a doctor or hospital who accepts Medicare in CT or goes to the ER while on vacation in FL, her costs of care will be paid by Medicare.
Medicaid, however, is a joint federal & state entitlement which is administered by each state uniquely. Each state funds it's program all slightly differently. Medicaid -wriiten into law in the 1960's- was planned to be a safety net for those determined to be "at need" BOTH medically AND financially. For the elderly, it was dedicated (set in law) to pay for skilled nursing services in a nursing home for the medical part and available to those impoverished for the financial part. But as its administered by each state, each state has the ability to use some Medicaid $ for waiver programs rather than pay just for NH. Some states have huge waiver programs covering all sorts of services; other states have just a few. Like for example, a few states use waiver $ to pay for AL but most states do not ever use waiver $ to pay for AL. Right now the trend for waiver funding is into PACE or other PACE like community based centralized day care program which keeps the elder in their home. If Maine has PACE, grannie may need to be evaluated for participation in that before she could be covered for a NH or for other individualized services.
Some states are more socially conscious - Minnesota - as to how funding is done to provide for social services for all their residents. Other states -Mississippi - not so. A lot of this depends on the wealth /income & political viewpoint in the state. Maine is kinda a low income state compared to CT, you may find that ME's programs are just not & will never be as generous & readily available as in CT.
States can require that the applicant can clearly show they are a resident of the state. Like have state drivers license or state issued ID, banking address in the new state, have awards letters (the letter from SS or other retirement income that states what income they get each month) in their name at an address in the new state. If grannie owns any property in CT, that property will no longer be an exempt asset under Medicaid rules for ME.
It will not be simple. Please find out just what grannie will qualify for and be able to get before you move her from CT to ME. I would suggest you have 6 mos of her funds set aside to private pay for whatever level of care grannie needs as a safety net too. Good luck.
As soon as you leave the old state, services stop. You have to reapply in Maine and wait (months) for approval or denial.