Individuals concerned about the present or future cost of long-term medical care for themselves or a family member (whether rendered in a home, hospital or a nursing home) must give serious consideration to public assistance benefits which may be available to them under the Medicaid program (sometimes referred to as “Title XIX”).
Medicaid is a joint federal/state welfare program which essentially pays for the medical expenses of any qualified individual who is indigent or impoverished. It also applies to individuals age 65 or over (or under the age of 65, but who have been determined to be social security disabled) who may not be “indigent” or “impoverished”, but still may find themselves in need of financial assistance to meet their long-term care needs.The federal government has established the basic guidelines for the Medicaid program and states which participate, like Connecticut, are in charge of administering them.States are also given the flexibility to modify or expand upon the basic federal guidelines and receive partial reimbursement from the federal government for the expenses they incur.
The body of Medicaid law is contained in Title XIX of the Social Security Act.Medicaid should not be confused with Medicare which is a federal health insurance program contained in Title XVIII of the Social Security Act.Medicare is an entitlement program generally administered by the Social Security Administration and usually available to anyone older than 65 or disabled who has paid into the Social Security system.Medicare and related programs currently in existence resemble many private health insurance programs in their use of deductibles, co-insurance and rate structures to determine the extent of one’s coverage.Conversely, if a person is eligible for Medicaid, typically the entire cost of medical care is covered without such impediments to coverage.
In Connecticut, the Medicaid program is administered by the Department of Social Services. The Department’s main office is in the City of Hartford with various regional offices and sub-offices throughout the state which receive and process applications for benefits.The Department also publishes regulations found in the Uniform Policy Manual.Periodically the U.P.M. is updated to reflect changes in federal and state Medicaid law and regulations.
Since Medicaid rules and regulations are quite complex and change frequently, caution must be exercised by those counseling individuals and their families.Moreover, since the federal government allows states participating in the Medicaid program to establish differing criteria for eligibility, the laws, rules and regulations in affect in one state may not necessarily apply in another. For these reasons, those seeking assistance with their long-term care planning are strongly urged to seek professional advice from a competent and experienced elder law attorney familiar with Medicaid in their state before taking any steps to secure Medicaid eligibility for themselves or others.
Our law firm has met the legal needs of Connecticut’s aging population for many years.Medicaid planning, as well as assistance with the Medicaid application process itself, has been an important part of our elder law practice during this time.We continue to bring special skills to each client’s unique situation and offer solutions to such common concerns as wealth preservation, asset and income management, planning for disabled spouses and special needs children, and developing estate and disability plans through important legal documents such as wills, trusts, durable form powers-of-attorney and advance health care directives.