Length of Time Medicaid Pays for Nursing Home Care

Last updated: June 08, 2020
Medicaid Long Term Care | Questions and AnswersCategory: BenefitsLength of Time Medicaid Pays for Nursing Home Care
medicaidplanner Staff asked 4 months ago

How long can you stay in a nursing home with Medicaid paying the bill?

1 Answers
medicaidplanner Staff answered 4 months ago

There is no limit as to how long you can reside in a Medicaid-funded nursing home, given you continue to meet long-term care Medicaid’s eligibility criteria.

In order to remain eligible for nursing home Medicaid, you must continue to have a functional need for nursing home care, or stated differently, require a nursing facility level of care. Learn more about a nursing home level of care here. Additionally, you must continue to meet Medicaid’s financial criteria, which means you must continue to have limited income and assets. See state specific financial requirements.

To determine if you continue to meet Medicaid’s criteria, and hence, continue to qualify for nursing home Medicaid, redeterminations are done at least every 12 months. (Redeterminations are also called renewals). Essentially, during the renewal process, you or your legal guardian will likely be required to fill out a redetermination application. You may also be required to submit documentation of your current gross monthly income and the value of your countable assets. Learn more about Medicaid renewals here. As part of the renewal process, a functional needs assessment will also need to be completed to ensure you continue to require a level of care consistent to that which is provided in a nursing home facility.

Please note; while you can continue to stay in a nursing home funded by Medicaid as long as the eligibility criteria continues to be met, Medicaid will attempt to collect reimbursement of funds for which it paid for your nursing home care after you pass away. This is done through a program called Medicaid estate recovery, and all 50 states have, and utilize, this program. Generally speaking, Medicaid beneficiaries have very little remaining assets of any value at the time of their passing. However, for Medicaid eligibility purposes, the home of a Medicaid applicant / beneficiary is often exempt from Medicaid’s asset limit. If the deceased Medicaid beneficiary still owns a home at the time of his / her death, it is through this asset that the Medicaid agency generally attempts to collect reimbursement. More about Medicaid estate recovery.

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