Medicaid

A state assistance program that pays medical bills for those who cannot afford to do so.

The Medicaid program is administered by the state and funded by both federal and state governments. Medicaid pays for medical care for individuals with very limited assets and income or those who cannot afford to pay their medical bills.

Mercer County’s Area Agency on Aging initially screens the perspective nursing home. This is referred to as an “Option Assessment.” This assessment may occur either at a private residence or when hospitalized and is geared toward the most appropriate and least restrictive level of care.

Criteria for eligibility:

• Must be a U.S. citizen.
• Must be deemed medically necessary to reside either temporarily or permanently in a long term care (LTC) facility.
• Must meet financial requirements.

Medicaid does pay for nursing home care for those patients deemed eligible.

Medicaid is administered by the County Assistance Office of the Department of Public Welfare. In order to file for eligibility, an application must be filed with the Department of Public Welfare.

Generally, the income of the applicant is counted as available for medical expenses including nursing facility care. This income includes social security, pension and interest from savings and investments.

SPECIAL NOTE: The applicant’s income for the time period in which the application was pending, generally is owed the facility once the application is approved. This income should not be spent by the resident or family during pendency of the application.

Once approved for Medicaid benefits, the following are services covered:

• Earned income toward room and board
• Medication
• 24-hour nursing care
• Durable equipment such as walkers, wheeled chairs
• Nursing supplies such as oxygen, Attends pads
• Hair care
• Treatment by a physician, dentist, or podiatrist
• Eye care
• Hearing aids
• Therapy: speech, physical, or occupational
• Transportation to and from medical services