Illinois Medicaid Changes: Look-back for Finances Increases to 5 years

Medicaid, the health insurance for very low-income seniors, pays for nursing home care ongoing.  Medicare, the health insurance for all seniors who have income over what is deemed low-income by each state, does not pay for nursing home care.  This matters, because nursing homes can cost as much as $400 per day which means someone with substantial savings can spend so much money on senior care services that they will then meet the poverty level for their state and qualify for Medicaid to pay for their nursing home stay for as many years as they may need the care.

The recent recession has resulted in lower tax revenue for states.  And, in Illinois, the former governor who was impeached also made so bad moves that have left the state with a huge debt and behind on paying their bills.  Medicaid is both a federal and state program, meaning the states must be able to help finance the costs.

Paying for a nursing home for as many years as a person may need it can get rather costly.  Right now, in Illinois, there is really no "in-between" care program for seniors on Medicaid.  If you need care services, the state of Illinois will pay for it in a nursing home, not at home. 

The state of Illinois now will now make it possible to "look back" at a senior's finances for 5 years, instead of 3 years.  The lengthening of the look-back period will enable the state to be sure that money wasn't given away if you really could afford to pay for the nursing home care on your own (seniors may gift the money to their children so they will have some inheritance, rather than using this money to pay for their nursing home care and now there are limits on how much money can be "gifted" in order to qualify for Medicaid).  This requirement was added because in the past there were some very wealthy families who were asking for the state to pay for their nursing home care and pretending they had no financial resources when they had really just given all their money away to a loved one.

However, senior care costs can add up.  Many seniors who may suffer from memory loss, can need care for 10 years or more.  Their families must plan ahead to pay for the costs of care and many times spending their assets down to qualify for Medicaid will be a natural progression for them.

Illinois Medicaid may now look at every transaction for the past 5 years to determine whether money was given away.  If money was given away, Medicaid will asseess a penalty period during which it will NOT pay for care.  Families will now need to examine their finances in detail before they apply for Medicaid so that there are no surprises later.  This will require detailed record-keeping inorder to switch from Medicare to Medicaid.

Illinois nursing homes accept Medicare or Medicaid or private funds as payment.  Medicare will pay for a short-term nursing home stay (usually for up to 20 days after a major medical event and hospitalizaton).  Research nursing homes in Illinois to understand their costs and ratings before you need one.

Nursing homes in Illinois range from $471 per day (Covenant Health Center in Northbrook, Illinois) to $102 per day at Grange Nursing Home in Mascoutah, Illinois.  You may view the daily costs and ratings of all nursing homes in Illinois on Caregiverlist's Nursing Home Directory.  Senior home care is another option for seniors who are private paying for senior care, as senior home care agencies provide professionally managed caregivers and this delivers one-on-one care to the senior.  Most nursing homes staff 1 Certified Nursing Aide to as many as 10 or more patients.  You may also request costs and services from senior home care agencies near you to plan ahead for senior home care.


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Comments (1) -

  • They must do something about Medicaid so people will be able to afford the rising costs of care.

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