If you or a loved one needs long term care, then Medicaid can potentially pay for this care, whether in a nursing home, assisted living facility, and even at home. However, some seniors are medically frail and need more extensive care in a nursing home setting. Many Indiana nursing home residents who qualify for Medicaid do not have to pay for most of their nursing home costs because Medicaid pays for the brunt of them. Here’s a brief overview of what Medicaid can offer you and how elder law attorneys can help to ensure that you qualify for long term care benefits.

What Are The Advantages Of Indiana Medicaid?

Indiana’s Medicaid programs include Healthy Indiana Plan, Traditional Medicaid, Hoosier Care Connect, Hoosier Healthwise, Medicare Savings Program, HoosierRx, MED Works, Program of All-Inclusive Care For The Elderly, and Medicaid Home And Community Based Services.

Traditional Medicaid

In Indiana, Traditional Medicaid provides you with health care benefits if you have low income and assets. Traditional Medicaid covers:

  • Members in nursing homes, state-operated facilities, and intermediate care facilities for the intellectually disabled.
  • Members who are dually eligible for Medicaid and Medicare.
  • Members who are eligible for home and community-based services.

Notably, Traditional Medicaid has a full range of services, including hospital care, doctor’s visits, wellness visits, well-child visits, clinic services, prescription drugs, over-the-counter drugs, lab and x-ray services, mental health care, substance abuse services, medical supplies, equipment, home health care, nursing facility services, dental care, vision care, physical therapy, speech therapy, hospice care, emergency and non-emergency transportation, family planning services, routine foot care, surgical foot care, chiropractic services and more.

If you want to know whether you are eligible for Traditional Medicaid, you should review the state’s eligibility guide. If you are a disabled individual who is institutionalized or eligible for a home- and community-based waiver, then you qualify if your income and assets fall within the state’s limits.

What Are The Disadvantages Of Medicaid?

Since Medicaid is a needs-based program, not everyone will qualify for benefits. For example, to receive long term care, you’ll need to show that you are eligible financially and medically. Many people who need long term care have income or assets that exceed the state’s limits, preventing them from getting benefits.

Another potential disadvantage relates to the quality of care. Medicaid does not offer an endless list of solutions to your medical problems. In some cases, if you suffer an injury or illness while on Medicaid, you may be limited in treatment options. This means that any treatment which is experimental or viewed as unnecessary might be denied. Also, a Medicaid nursing home will likely not measure up to a luxurious private nursing home facility. However, Medicaid aims to ensure that you are comfortable and receive proper treatment, and many seniors have been satisfied with the care they receive through this government program.

Does Medicaid Pay Retroactively?

Retroactive eligibility helps people dealing with unexpected injuries or illnesses that can’t pay for their care and have not sorted out what they must do to obtain government benefits. Medicaid applications take some time to process – it doesn’t happen overnight.

Fortunately, if you apply for Medicaid, you can receive nursing home benefits that apply up to three months before your application. Suppose that you met Medicaid’s eligibility guidelines in June when you moved into a nursing home. If you applied for Medicaid in September, Medicaid would cover your unpaid nursing home expenses since June.

How Do I Know Whether To Apply For Medicaid?

For starters, you should investigate the types of Medicaid that Indiana offers to see if you can obtain the care you need through these programs. Each Medicaid program has different services and eligibility criteria. Secondly, if you need long term care, you may be best served by consulting with a Medicaid planning attorney who can evaluate your finances and healthcare needs and help you qualify for benefits.

It is important to note that a lot can go wrong with completing your Medicaid application without the help of an attorney. It is better to have peace of mind knowing that a trained professional is involved in helping you protect your assets and get the benefits you need.

Indiana Medicaid Lawyer

To learn more about applying for traditional Medicaid in Indiana, contact a Medicaid planning lawyer. Click here to learn more about Indiana Medicaid planning strategies.

About The Authors

Jeff R. Hawkins and Jennifer J. Hawkins co-author this blog with Thomas E. Hynes, a lawyer admitted to practice in Pennsylvania, New Jersey and Florida who has a background in estate planning and elder law. Jeff and Jennifer are Trust & Estate Specialty Board Certified Indiana Trust & Estate Lawyers. They are also active members of the Indiana State Bar Association and the Indiana Chapter of the National Academy of Elder Law Attorneys (NAELA). Jeff is also a member of the Illinois NAELA Chapter.

Both Hawkins are admitted to practice law in Indiana, and Jeff Hawkins is admitted to practice law in Illinois.

Jeff is a Fellow of the American College of Trust and Estate Counsel and the Indiana Bar Foundation. He is also a member of the Illinois State Bar Association and he served as the 2014-15 President of the Indiana State Bar Association.

More Information

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