Medicaid: The safety net for long term care

p/> To qualify for Medicaid, you have to have a low income (but most states will take your medical costs into account when your income is determined, so high medical bills can make middle-income people eligible).

If you’re married, and only one of you needs nursing home care, the spouse who lives in the community instead of in a nursing home, can still have income and assets that are above Medicaid limits.

This is an improvement on the days when both spouses had to be impoverished if one spouse needed Medicaid. And another improvement is due in 2014: The Affordable Care Act expands this financial protection to include situations where the spouse needing long-term care receives help at home, not in a nursing home.

The new health care law also includes steps designed to improve Medicaid’s home-based long-term care options. So if you do need Medicaid, new options will let you get the help and care you need to live safely and successfully at home instead of being forced to move to a nursing home.

But these changes over the next few years won’t happen if Medicaid doesn’t stay a strong program, with adequate funds, or if the Supreme Court strikes down the health care law. The Supreme Court will reach its decision at the end of June, and Congress is likely to debate deep budget cuts in Medicaid over the next several months.

So as you enjoy the spring weather, don’t forget to think through your possible long-term care needs. And keep in mind that if your best-laid plans go awry, as long as we make sure that Medicaid stays a strong program, there will be a safety-net there to help you, just in case.

Ron Pollack is executive director of Families USA.

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