What requirements must be met for Long-Term Care (LTC) approval for someone on Medicaid?

For Long-Term Care (LTC) approval for someone on Medicaid, it is essential to meet financial and medical/functional eligibility requirements. Financial eligibility typically involves ensuring that the individual’s income and assets fall below certain thresholds set by Medicaid. This ensures that assistance is provided to those who need it the most based on their financial situation.

Medical/functional eligibility requires a comprehensive assessment to determine if the individual needs the level of care that LTC provides. This evaluation often considers factors such as the individual's ability to perform daily activities (such as bathing, dressing, or eating) and the presence of any medical conditions that necessitate supervision or assistance.

These two main categories of eligibility—financial and medical/functional—are fundamental in assessing whether an individual qualifies for LTC services under Medicaid. This approach ensures that support is directed to individuals who have genuine needs for long-term care services due to their health conditions while also maintaining a safety net for those with limited financial resources.