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What the Future Holds for Medicaid

A Place for Mom Staff
By A Place for Mom StaffNovember 7, 2014

Want to know how the current and forecasted state of Medicaid will impact long-term care? Read the following article contributed by Medicaid planning experts at Senior Planning Services to learn more.

What the Future Holds for Medicaid

There is no question about it; Medicaid is definitely on the table for reform, both, on the federal and state levels. The gargantuan number of baby boomers retiring each year will force regulation changes. Having worked for Senior Planning Services, an industry leader in Medicaid Planning and consulting for many years, I’d like to share some of the current and forecasted facts and figures and what they mean for long-term care.

Important Medicaid Questions Answered

1. How big is the Medicaid budget?

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The 51-year-old program cost the federal and state government a whopping $415 billion, according to July 2014 figures. This 800-pound gorilla eats about 16 cents of every dollar in state general funds.

2. Who is covered?

  • 20% of severely disabled individuals
  • About 25% of all children including 50% of low-income children
  • About 35% of pregnant women and the cost of their birth.
  • About 45% of individuals with HIV/AIDS
  • 60% of poor or near-poor individuals
  • 60% of nursing home residents

3. How many seniors are there in the U.S.?

About 41 million, or 13.3 % of the population. They will account for 20% of the population by 2060. For more stats, click here.

4. How many seniors are covered?

About 60% of all seniors. Although seniors and disabled individuals account for only 25% of all Medicaid recipients, they use 69% of the total Medicaid budget. Children, by contrast, account for about half of those covered by Medicaid and they use only 19% of Medicaid dollars.

Enrollment and Spending in Medicaid

5. Who is eligible for Medicaid long-term care? 

This will vary from state to state. Medicaid is a federal and state-sponsored program, with the federal government covering about half of the budget. This explains why the program varies from state to state. As a general rule, though, one needs to be below the income and assets threshold of that particular state.

Some examples of income that are counted are:

  • Interest from bank accounts and dividends from stocks and bonds
  • Salaries and pensions
  • Social security or disability payments
  • Veteran benefits

Some examples of assets are:

  • A second home or vehicle
  • Life insurance policy with face value of $1,500 or more
  • Revocable trusts
  • Savings accounts, CDs, stocks, bonds, mutual funds and IRAs

6. Is anyone above the asset threshold ineligible, or can assets be spent to help eligibility?

Yes, there are many qualified purchases that can be made to lower your assets for Medicaid eligibility. However, the “spend-down” requires experience with the many Medicaid rules and regulations and attention to detail. Sometimes it is advisable to speak to a Medicaid planning and consulting company who can guide you through this process.

As one can glean from this Medicaid snapshot, with the 65+ population forecasted to reach 20% of the U.S. demographic by 2060, changes to the system are not a question of if, but rather, when.

About the Author

Senior Planning Services has Medicaid specialists that are well versed in all of Medicaid’s guidelines and identify and deal with any issues prior to the application being submitted. We have relationships with the Medicaid workers on both the County and State levels enabling us to deal with issues in the most efficient manner possible. Our relationships allow us to have the applications expedited and given the proper attention by the County worker assigned to each case. Our case managers make themselves readily available to our clients if any questions may arise at any point during the application process. We establish working relationships with the clients and their families making sure all information needed is gathered as swiftly as possible. All information is reviewed by our case managers and submitted to Medicaid as a complete package ensuring eligibility is obtained as quickly as possible.

Do you have any questions about Medicaid that wasn’t answered in this article? We’d like to hear them in the comments below.

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