Medical Assistance (Medicaid)

Medical Assistance (Medicaid) is a needs based program created at the same time as Medicare was created.  It is administered federally by the Centers for Medicare and Medicaid (CMS).  Medicaid was originally developed to provide medical assistance to mothers and babies.  It has grown into an insurance program that continues to benefit needy individuals, particularly those who qualify Supplemental Security Income (SSI).

However, most of monies in the Medicaid programs fund long term care payments, primarily in nursing homes for those who meet the financial and medical requirements.  Both the federal government (who provides 55 percent of the funding of this program in Pennsylvania) and the state governments are spending billions of dollars maintaining individuals in nursing homes across the country.  The states administer the Medicaid programs and the eligibility rules are specific to each state, although there is an “overlay” of federal rules to consider. 

Medicaid is a very complicated program.  Individuals who qualify for SSI have Medicaid as their medical insurance.  Some individuals on Medicare might also be eligible for Medicaid (dual eligible).  Some people qualify for Medicaid on limited basis when catastrophic needs occur, such as an auto accident or a severe health crisis and no medical insurance is available.  Medicaid pays for assistance at home for some qualified individuals through programs administered by the local Offices of Aging in Pennsylvania.  Medicaid does not pay for care in a personal care/assisted living facility in Pennsylvania at this point in time.  Most people are most familiar with Medicaid in a nursing home setting.

The elder law attorneys at OWM Law have significant experience with accessing the Medicaid program and understanding eligibility options.  It is especially important to consult a qualified elder law attorney if one spouse enters a facility and the other spouse requires financial protection.  Even if it a single person, there are still techniques to insure qualification for Medicaid in a timely manner.  Knowing your options can save a great deal of time and anxiety.

Additional Assistance

AGENCIES FOR AGING AMERICANS

Visit our "Local Agencies" links at right for topics of interest to senior citizens, including adult day care, Meals on Wheels, medical assistance, Medicare, nursing home facilities and assistance with placement in such facilities, in-home & residential personal care, senior centers, transportation for senior citizens, and other agencies of interest to senior citizens.

ELDER LAW HANDBOOK

The Montgomery County Bar Association has published an Elder Law Handbook that is specific to elders living in Montgomery County. It is now available online in Adobe Acrobat. (Due to the size of the Handbook, it may be slow to download.) This guide is also available in disc format from the Montgomery Bar Association, 100 West Airy Street, P.O. Box 268, Norristown, PA 19404-0268; telephone 610-279-9660; fax 610-279-4321.

Important Phone Numbers

Montgomery County APPRISE:
Federal program hosting information services on Medicare and other insurance services.

Norristown Office: (610) 278-3911
Chester County Office: (610) 344-5004

The Montgomery County Office of Aging and Adult Services 
Provides information regarding Aging Services, Adult Services and Community Services including referral services, casework and care planning, health and education programs, and long-term care services. Some locations include:

Central Office, Human Services Center, Norristown, PA: (610) 278-3601
Pottstown District Office, Pottstown, PA: (610) 327-9203


REFERENCES

RELATED LINKS