There have been a number of changes to the Medicaid Rules in the past few years that can make the process of applying for Medicaid Assistance more challenging, whether you are applying for Medicaid Assistance with home care or nursing home care.  A few of those changes are listed below:

• Changes in the Activities of Daily Living Requirements to qualify for Medicaid. Applicants were formerly required to demonstrate a need for assistance with two activities of daily living or one activity of daily living and significant cognitive impairment.  They are now required to demonstrate a need for assistance with either three activities of daily living or two activities of daily living and significant cognitive impairment.
• Medicaid Look Back Periods for Chronic Care (Nursing Home) is 60 months. A new law was passed that will impose a 30 month look back period for Community Care Medicaid.  Although that rule has not yet been implemented, its implementation is anticipated to go into effect in 2026.
• Change to retroactive Medicaid Coverage of Medical Bills from three to two months prior to application.
• The financial eligibility criteria for community care and nursing home care Medicaid Assistance Change every year. Ask us for our lates Medicaid Eligibility Guide.

Activities of Dailing Living Include:

• The ability to feed oneself
• Toileting and Incontinence
• Bathing
• Difficulty with Ambulation or Transferring
• Dressing
• For demonstration of Alzheimer’s or Significant Cognitive Impairment DOH Form 5821 must be completed by a physician.

If you or a loved one may need long-term care assistance, call us today to schedule a consultation so we can assist you in navigating the process.