St. Andrew’s Resources for Seniors System

The Role of Medicaid in the Care of the Elderly

Goals of Session

• Understand Medicaid• Be aware of the eligibility requirements • Have basic knowledge of what is covered by

each service

Page HeaderWhat is Medicaid?

• The federal/state health care program for low income and disabled people

• Can help pay for basic health care coverage• Can help pay for premiums, deductibles, and

co-pays under Medicare• Pays for long-term nursing home cost

Page HeaderWho is eligible?

• There are criteria that must be met:

Status

Income

Resources

3

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• Home• Household goods, personal effect and personal

keepsakes• Car• Life insurance• Property essential to self support• Income producing property• Burial space• Prepaid burial plan

Common Exempt Resources

Page HeaderWhat is covered?

• Inpatient hospital• Outpatient hospital• Physician services• Medical and surgical

dental services• Nursing facility services• Home health care• Lab and x-ray services

• Clinic services• Intermediate care

facility • Optometrist services

and eyeglasses• Prescribed drugs• Prosthetic devices• Dental services

Page HeaderPrograms available?

Home and community based services • Helps people stay in their homes longer with

services like homemaker chore or respite services

Program for all-inclusive care for the elderly (PACE)• Designed to give the frail elderly the help they

need to delay or avoid nursing home care

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• Medically urgent and non-emergent transportation

• Physician services• Medication and pharmacy services• Dental care including dentures• Podiatry care• Eye and ear care• Ongoing rehab

PACE Services

Page HeaderPACE Services

• Hospital care• Assisted living and nursing home care • Home health and home chore assistance• Substance abuse counseling• Mental health care services• Nutritional services• Medical equipment• Planned social activities