FAQs

What is Medicaid?

Medicaid is a federal government program that pays for the cost of nursing home care for seniors and disabled individuals who meet certain eligibility criteria. Although Medicaid is a federal program, state law governs how the program is administered within each state.

Because Medicaid is a government benefit program, many people mistakenly believe that it exists only to help people with extremely limited income or assets. Or, to put it more bluntly, many retirees think: "Medicaid is just welfare, and welfare is for the poor." This is absolutely false. Do not fall into the trap of thinking that because you own a home and have saved for retirement that Medicaid is not an option. Medicaid is available to help anyone who qualifies, and many people have qualified while protecting the assets they have worked so hard to attain throughout their lives.  

How do I qualify for Medicaid in North Carolina?

Medicaid imposes both financial and non-financial requirements in order to qualify for benefits in North Carolina. To establish non-financial eligibility, applicants must be: a U.S. citizen or qualified alien, a resident of North Carolina, and aged 65 or older, or disabled. Additionally, Medicaid applicants must require a “nursing home level of care,” which means that their medical needs can only be met in a skilled nursing facility.  It is important to keep in mind that skilled nursing facilities are different from assisted living facilities (a.k.a. adult care homes).

In establishing financial eligibility for Medicaid, applicants must demonstrate that both their income and assets fall within certain limits. Therefore, the distinction between what counts as income and what counts as an asset is critically important. It is important to note that the Medicaid eligibility rules are very complex, and much of the “advice” that people get from the internet or family is either outdated, partially correct, or worse, dead wrong. The only way to ensure that you can qualify for Medicaid while protecting as many of your assets as possible is to speak with a qualified attorney.

Why do I need Medicaid if Medicare will cover the cost of nursing home care?

Medicare is a federal health care insurance program for individuals who are over age 65 or disabled.  In general, it does not cover the cost of long-term care in a nursing home. 

However, Medicare will cover a short-term stay in a skilled nursing facility under certain circumstances.  If a senior has been admitted to a hospital for more than 72 hours and is then moved to a skilled nursing facility within 30 days of the initial hospitalization, Medicare Part A will cover up to 100 days at the nursing facility.  Additionally, Medicare only fully covers the first 20 days of skilled nursing care, which means that a stay of longer than 20 days will incur an out-of-pocket cost. Although Medicare may cover a short-term stay at a nursing facility, it will not pay for the cost of long-term care.