OWM Attorneys At Law
O'Donnell, Weiss & Mattei, P.C.


Using Medicaid To Your Advantage

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 Services (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 for Supplemental Security Income (SSI).

However, most of the money in the Medicaid programs funds long-term care payments, primarily in nursing homes, for those who meet the financial and medical requirements. Both the federal government (which provides 55 percent of the funding for 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.

A Lawyer Can Help

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 a 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. Most people are most familiar with Medicaid in a nursing home setting.

Because of all these complications, it is crucial to speak with a lawyer if you plan to utilize Medicare or Medicaid. 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 is a single person, there are still techniques to ensure qualification for Medicaid promptly.

Contact The Firm Today

Knowing your options can save you a great deal of time and anxiety. The elder law attorneys of O'Donnell, Weiss & Mattei, P.C., have significant experience with accessing the Medicaid program and understanding eligibility options. You can reach our office by calling 610-323-2800 or by sending us an online message. One of our skilled attorneys will get back to you promptly.