Seniors need to understand the rules for Medicaid eligibility, as well as the coverage rules for Medicaid. This is very important to older people, even though most seniors have Medicare. Medicare and Medicaid are very different programs, which have different coverage rules.
While Medicare can pay for hospital care, some routine medical services, prescription drugs, and brief stays in a nursing home for skilled medical care, Medicare does NOT pay for routine custodial nursing home care. Most people who must spend time in a nursing home only need routine custodial care for which Medicare will not pay. Since Medicare and private insurers do not pay for nursing home care, the only options are Medicaid, private pay or specialized long-term care insurance.
Because Medicaid may be the only choice for coverage for nursing homes, it is important for people to understand eligibility rules and to plan ahead to qualify for Medicaid when care is needed. Medicaid can pay Medicare premiums and co-insurance costs and cover other things for which Medicare will not pay. Because Medicaid can be more comprehensive than Medicare, seniors should take time to research their coverage options as early as possible so they can make sure they are able to afford care. Parman & Easterday can assist seniors with the creation of a personalized Medicaid plan. We have also prepared some links to important Medicaid resources below.
Many people do not understand the basics of the Medicaid program: These resources can help:
- The Medicaid.gov List of State Resources: The federal government works in connection with the states to deliver Medicaid benefits to seniors who need services. While the federal government provides funding, states set many of the coverage and eligibility rules within the federal guidelines. This page provides access to state-specific resources and details on how Medicaid is administered on the state level.
- The Oklahoma Healthcare Authority: This provides links to apply for Medicaid coverage, to learn about Medicaid in Oklahoma for seniors and the disabled, and to find out about enrollment and benefits. In Oklahoma, Medicaid is called SoonerCare.
Eligibility is of primary concern to seniors. To find out eligibility rules for Medicaid and Oklahoma, take advantage of these resources:
- The Medicaid.gov page on federal eligibility rules: This page provides basic details on the modified adjusted gross income rules and other financial regulations for qualifying for Medicaid. While states have varying rules on eligibility, this federal website provides good basic information for those who want to apply for benefits and who need help understanding the financial requirements their state imposes.
- The Oklahoma online application website: This website allows you to apply to receive coverage through SoonerCare. You can also access your account online and can obtain information on the program, on benefits, and on SoonerCare policies. There is even a step-by-step guide to follow to make applying easy, and there is information you can review before you start the application process so you will know what to expect and what you need when you are trying to seek benefits coverage.
To learn more about how Medicaid benefits provide you with care and to find out how to use your Medicaid benefits, these resources are beneficial:
- Health and Human Services’ guide for finding a doctor who takes Medicaid: Medical care providers are not obligated to accept Medicaid coverage, and Medicaid reimbursement rates for providers are lower than private insurance or Medicare reimbursement rates. As a result many doctors don’t accept Medicaid insurance. This guide from Health and Human Services, which is a federal agency, provides some basic introductory information on how patients can look for a qualified doctor in their area who accepts their coverage.
- The KanCare guide to health plans and managed care organizations: This provides information on the different health plans or managed care organizations which provide services to Medicaid patients who are enrolled in the KanCare program.
- The Oklahoma Health Care Authority’s Provider Database: Using this resource, you can find providers who accept Medicaid coverage in Oklahoma. You can find providers offering services in a wide array of different areas of specialization.
For those looking for a nursing home covered by Medicaid and which provides quality care to seniors, this is an invaluable resource:
- Nursing Home Compare: A searchable database provided at this link offers information on nursing home ratings and on nursing homes which accept Medicare and Medicaid. Finding a good nursing home is exceedingly difficult, and this resource is a good starting off point for research to make sure a home you are considering does not have a lengthy history of patient care problems.
Each of these different resources can help you to understand more about the Medicaid program and about how it can work to help you. If you want to make sure you take the right steps to secure Medicaid benefits, you should contact an experienced attorney for personalized advice.
Getting Legal Help with Medicaid
Parman & Easterday provides assistance to seniors who want to protect their assets and ensure these assets do not disqualify them from receiving Medicaid when they need it. Give us a call today at (405) 843-6100 or contact us online to find out more about the personalized help our legal team can provide you in getting Medicaid coverage when you need it. today.