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Medicaid At A Glance 2015 Reference Guide

The Alabama Medicaid Agency has a number of programs for the elderly and disabled. Medicaid for Institutional care is for people in nursing homes, hospitals and ICF-MR facilities. Home and Community Based Waivers are for people who are elderly, disabled, homebound, mentally retarded, or who have certain diagnoses and who live in the community. SSI Related Medicaid programs are for people who no longer receive Supplemental Security Income (SSI) payments, but have their Medicaid benefits protected under certain laws.

MEDICAID AT A GLANCE 2015 REFERENCE GUIDE

(This reference guide is not to be considered as legal advice on how these guidelines may affect your ability to qualify for benefits or assistance.) 

The Alabama Medicaid Agency has a number of programs for the elderly and disabled. Medicaid for Institutional care is for people in nursing homes, hospitals and ICF-MR facilities. Home and Community Based Waivers are for people who are elderly, disabled, homebound, mentally retarded, or who have certain diagnoses and who live in the community. SSI Related Medicaid programs are for people who no longer receive Supplemental Security Income (SSI) payments, but have their Medicaid benefits protected under certain laws.

To be eligible for the Medicaid programs listed above, you must:

  • Be living in Alabama,
  • Be a U.S. citizen (You must provide proof of citizenship and identity unless you have been approved for Medicare or SSI.), or be in satisfactory immigration status (You must provide proof of immigrant status.),
  • Meet certain medical criteria,
  • Have a monthly income below a certain limit, and
  • Have resources below a certain limit.

NOTE: Eligibility for Home and Community Based Waivers (page 5) depends on the availability of slots from the administering agency.

Nursing Home, Hospital, and ICF-MR Medicaid for an Individual:

Medical Approval. An applicant must be medically approved by Medicaid or Medicare for the nursing facility to be paid. The nursing facility must submit the medical information to Medicaid. An applicant for Nursing Home, Hospital, or ICF-MR Medicaid must also be a resident of an approved medical institution for at least 30 continuous days to be eligible for Medicaid payments. (The exception is an SSI recipient.)

Income Limit. The income limit for Nursing Home, Hospital, or ICF-MR Medicaid is $2,199 per month for an individual. (This income limit changes each January.)

Income:

  • Social Security Check
  • Pensions
  • Retirement

Resources:

  • Cash in Savings Account
  • Cash in Checking Account
  • Any Stocks, CD, Bonds
  • Any cash value on Burial Policies, Life Insurance Policies

Requirements:

  • Need to meet Medical Necessity to qualify for assistance from the state
  • Need to meet Financial to qualify for assistance from the state
  • Can take up to 45 days to receive an answer from the state
  • Resident will need to give up their social security check and all their income to facility to help to contribute towards their care
  • Resident is allowed to keep $30.00 out of their income for their personal needs
  • Complete a Medicaid application with the Alabama Medicaid Office (see our Business Office)
  • Must remain in the facility for 30 consecutive days (hospital day also count)
  • Meet with ADPH case worker as directed

The State determines whether resident will qualify or not. For more information click here.