Understanding the Medically Needy Program for Medicaid

On Behalf of | Sep 29, 2022 | Firm News

If you are aging, you may be thinking about how you will pay for long-term care, in the event you need it. Assisted living, nursing homes and other medical expenses add up quickly, and people can rip through their savings and assets before they know it.

Medicaid is a program available for low-income individuals, and it helps pay for a variety of medical and healthcare costs. One must meet certain eligibility requirements to receive Medicaid. However, there are ways that ineligible applicants can become eligible, and one way is via the Medically Needy Program.

Medicaid eligibility

According to Medicaid.gov, there are certain mandatory eligible groups, such as qualified pregnant women. However, income is the main qualifying factor for all others. Older individuals who require medical care or assisted living accommodations must meet these requirements as well as others, such as living in the state in which they would receive Medicaid and be U.S. citizens or lawful permanent residents.

Medically Needy Program to help meet eligibility requirements

Older individuals who do not originally qualify for Medicaid may benefit from the Medically Needy Program. According to the Florida Department of Children and Families, this program, also known as the share the cost program, allows individuals to spend down their income with qualifying medical expenses.

Each month, enrolled individuals must meet a pre-determined share the cost amount based off their income and household size. Allowable expenses used towards this amount include:

  • Health insurance premiums
  • Paid medical bills
  • Medical bill co-pays
  • Doctor-prescribed medical services
  • Transportation for medical care

Once individuals submit expenses equal to, or more than, their share the cost amount, they are eligible for Medicaid for the remainder of the month.