The truth is that State Medicaid programs are complex and many of us have preconceived notions about Medicaid coverage of nursing home care. Here are 10 common myths about Medicaid in the nursing home setting:

1. Medicaid coverage means substandard care.
False. Providing substandard care to Medicaid recipients and discriminating based on the resident’s pay status is illegal under both state and Federal law. Besides, typically the caregivers and staff do not know which resident is a Medicaid recipient as there is no public identification of pay status.
2. You must be poor or broke to qualify for Medicaid.
False. You may own property and qualify for Medicaid as certain assets are non-countable or exempt under the Medicaid regulations.
3. You must transfer or hide your assets to protect them.
False. This is a crime. While it is not illegal to plan or structure your assets in order to qualify for Medicaid nursing home benefits, you must fully disclose the details to the State Medicaid agency.
4. The state will take your house to qualify you for Medicaid.
False. In most states, the resident can maintain a principal residence and will not be a countable asset if a spouse or specific individuals live in the house. Keep in mind that there are estate recovery laws which allow the state to seek reimbursement from your estate to recover Medicaid costs after your death.
5. You cannot qualify for Medicaid after you have become a nursing home resident.
False. You may qualify for Medicaid benefits prospectively even if you entered the nursing home in private pay status. There is a disclosure requirement – you must disclose up to 5 years of financial records and transactions when applying for Medicaid coverage.
6. Once you become eligible for Medicaid, you remain eligible permanently.
False. Medicaid is not for life but once your eligibility is established, it will be maintained unless your circumstances change (i.e. inheritance, settlements, sell an exempt asset, Medicaid rules change).
7. Medicaid will not cover all the nursing home care and services you want.
False. There is no difference in the type of care or services available to Medicaid recipients as they are entitled to the same nursing home services as other residents.
8. All nursing homes accept Medicaid patients.
False. Although a large percentage of nursing homes accept Medicaid recipients, not all of them do. There are some that will transfer you to a Medicaid nursing home if you spend down your resources in a non-Medicaid nursing home, then qualify for Medicaid.
9. Your agent under a Power of Attorney can retitle your property to qualify you for Medicaid.
False. It depends on the type of Power of Attorney. Many power of attorney documents do not contain the gifting provision or power to make gifts. The power to do so must be explicitly granted to the agent.
10. Your income may to be used to pay for your spouse’s nursing home bill.
False. In the majority of state, only the income of the nursing home spouse is used to pay the nursing home expenses.

Here at Schutjer Bogar, we assist you with the often grueling Medicaid eligibility process so that you can focus on what matters most – your health.

Monica works out of our Manhattan office with Trisha Cowart