What Is Community Medicaid?

Medicaid is a federal program administered on a state-by-state basis. There are several types of Medicaid — including Community Medicaid.

Posted on October 8, 2022

Community Medicaid covers care and medical services that enable a recipient to remain in their home or community as long as possible instead of entering a skilled nursing facility or other institution. Community Medicaid can cover home health care, private nursing, personal care, assisted living programs, doctor appointments, wellness visits, hospital care, prescription drugs, laboratory services, occupational therapy, and more.

Are You Eligible?

Applicants for Community Medicaid must meet specific eligibility criteria. First, they must be disabled or over the age of 65. Second, they must not exceed certain income and asset thresholds to receive benefits. These criteria vary from state to state and adjust year to year. Excess income or assets can disqualify an individual or couple from qualifying for Medicaid benefits. However, there are legal planning mechanisms available to allow people to qualify.

Medicaid Waivers

Alternatively, there may be a Medicaid waiver program available in your state that allows you or a loved one to qualify for Community Medicaid. Medicaid waivers allow states to waive certain rules so more people can be eligible for specific programs.

In the case of Community Medicaid, waivers can offer long-term home and community-based services to more seniors or disabled persons who need help to remain at home or in their community. These waivers may allow them to access home attendants or health aides, adult day care, respite care, accessibility modifications to cars or homes, personal emergency response devices, medical equipment, and homemaker services.

Many of these benefits enable the elderly, disabled, or people with Alzheimer’s disease or dementia to receive long-term care services and live independently in familiar, comforting environments. So, while a person may have to pay for their housing, they can still receive care and support in their home, a relative’s home, assisted living facilities, specialized programs, or other “home-like” environments.

For more information on how your loved one may be able to qualify for Community Medicaid, reach out to an elder law attorney in your area.