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Assistance For Your Loved One Who Has Entered A Nursing Home
The following information may apply if you qualify for financial assistance from the Department of Job and Family Services in paying nursing home expenses for yourself or a loved one.
When applying for nursing home assistance, you are actually applying for two types of financial benefits, the first of which is called Medical Assistance. If you or your loved one qualifies for this type of assistance, you will be issued a "Medical Card" which will be sent to you each month to help pay for doctor visits, hospital expenses, prescriptions, dental work, etc. You may be eligible for the Medical Card if your total financial resources are $1,500 or less and your income is below a state-specified level. A caseworker from our agency will help to determine your eligibility as part of the application process.
The other benefit is called Vendor Payment. This benefit helps to pay for a portion of the daily room and board expenses incurred at a nursing home. The portion you pay, called "Patient Liability," is calculated based upon your total gross income, minus a $40 monthly personal needs allowance and any supplemental medical insurance premiums that you pay. For example, if your gross monthly income is $600 and you pay an AARP secondary medical insurance premium of $75, then your patient liability would be:
$600 (income) - $40 (allowance) - $75 (premium) = $485 (patient liability)
In this example, you would be required to pay the nursing home $485 at the beginning of every month for which you are eligible to receive the Vendor Payment benefit. The Vendor Payment provision would then pay for the balance of the monthly nursing home bill.
If you have a spouse who is not in the nursing home, the patient liability is figured differently than described above. In such cases, your spouse may be eligible to keep a portion or all of your income to help pay for housing and living expenses in the community.
This is an abbreviated overview of nursing home services available through the agency. For more information, please contact us. We will be happy to assist you in applying for nursing home assistance, and in answering any questions you may have.
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