Nursing facilities: What is and what is not paid by Medicaid

| Jan 27, 2021 | Medicaid Planning And Asset Protection |

Elder Americans have many concerns about what will happen to them if a day comes when they can no longer care for themselves. For those with limited financial resources, aging and the possible need to enter a nursing facility are especially worrisome. Fortunately, the Medicaid program can offer a solution for elders, but what does the program pay for in a nursing home or facility?

According to federal requirements, Medicaid covers many expenses to ensure residents live comfortably in a nursing facility. Continue reading to discover what the program will and will not cover.

What will Medicaid cover?

The list below contains several examples of items and services which come without charge to the resident.

  • Nursing and care services
  • Social services (medically related)
  • Some rehabilitative services
  • Medication services (acquiring, administering, etc.)
  • Activity programs and services
  • Individualized dietary services
  • Emergency and general dental services
  • Bed and board maintenance and services
  • Hygiene items and services

This coverage helps ensure that residents on the Medicaid program will receive health care in a nurturing environment.

Items and services not covered by Medicaid

Unfortunately, Medicaid cannot pay for everything a nursing facility resident may want. Below, you will find a short list containing examples of non-covered services.

  • Private rooms (unless medically necessary)
  • Personal items (cosmetics, clothing, books, etc.)
  • Special foods or drinks
  • Plants and flowers
  • Phones, radios and televisions
  • Special activities or events

As you can see, Medicaid ensures that nursing home residents in East Hanover and other areas receive the most basic care and benefits. However, Medicaid planning with guidance from an elder law professional can improve your quality of life when the time comes to enter a facility. Such guidance helps you qualify for the New Jersey Medicaid program while taking steps to protect the assets you possess.

Our website contains additional insight into the state’s Medicaid program. Please, keep reading to learn more.