In Delaware, you or a family member can apply for the Medicaid Nursing Facility Program to receive medical assistance and care. If you are interested in applying, learning the eligibility requirements can make a difference in your application.
Here are three factors you must consider when preparing your Medicaid application:
Medical eligibility
You or a family member may apply for the program, provided that you require a Nursing Facility Level of Care (NFLOC). This means you have a medical condition that requires full-time care and supervision, which can be provided by a nursing home.
The Division of Social Services Pre-Admission Screening (PAS) unit will determine if you need NFLOC. They will evaluate whether you have physical and mental disabilities that hinder your ability to perform daily living activities. These can include bathing, dressing, cooking and toileting.
Financial eligibility
To be financially eligible, your income and total assets must be below the specific limits set by Medicaid. The conditions vary depending on the household setup:
- For single applicants: Your monthly income must be below $2,417.50 and your assets must be under $2,000.
- For married individuals where both are seeking to apply: Each spouse’s monthly income must be below $2,417.50 and your combined assets should be less than $3,000.
- For married individuals where only one spouse will apply: The monthly income of the applicant must be less than $2,417.50 and their assets must be less than $2,000. The non-applicant spouse can have assets up to $157,920.
If your income and assets exceed these conditions, there are options available for you to reduce them. However, it is crucial that you strictly follow Medicaid’s exemption guidelines to avoid penalties.
Preparing for your Medicaid application
Medicaid planning is a must for individuals considering long-term care. To help you effectively prepare your application, online resources are available for your perusal.
However, the complexity of the application process can be overwhelming. It is possible to miss important details that could lead to penalties or the denial of your application. An experienced attorney can offer clarity on how the Medicaid process works. They can also provide advice on protecting your assets while remaining eligible for long-term care.