Also see

Qualifying
Trust

Medicaid
Lien


Spousal
Protection

Medicaid Financial
Application

Medicaid Functional
Application

See our
index for
information
regarding:

Caregiving

Health

Legal

Legislation

Managed Care 

Medicaid

Medicare

Medicaid is a federal and state benefit that pays for some or all of the following services:

- Physicians visits
- Inpatient and Outpatient Hospital Services
- Prescriptions
- Mental health care
- Home and community based care
- Transportation to medical appointments
- Nursing home care

How is Medicaid different than Medicare?

Medicaid goes to persons of all ages who meet low income guidelines. It provides a broader range of services than Medicare.

Medicare covers most people over age 65, regardless of income. The primary benefits are doctors' office visits and hospitalization. Home health and nursing home coverage are extremely limited.

Who Qualifies for Medicaid?

Recipients of Supplemental Security Income (SSI), and Aid to Families with Dependent Children (AFDC), automatically receive Medicaid. Individuals who receive Old Age Pension (OAP) are eligible for the Old Age Pension Health and Medical Fund. OAP recipients also receive Medicaid if they receive SSI. Individuals can also apply when they or a loved one need intensive in-home or nursing home care.

Applying For Medicaid to Cover Home Care or Nursing Home Care

To successfully complete the two-part process (the county has 45 days to process the financial application and the eligibility application part I and the eligibility application part II and the Options for Long Term Care Agency has 10 days to process the functional screening application and the assessment application after they receive approval from the county). Applicants may need professional help. Both functional and financial qualifications are required.

Applicants need the following documents:

- Social Security Card
- Latest checking and savings account statements (or passbook)
- Current rent receipt or house property tax statement
- Car or truck registration
- Any life insurance policies
- Proof of earnings if working
- Proof of income from sources such as pension, veteran's benefits, interest from investments, rentals or loans.
- Proof of age (birth or baptismal certificate)
- Proof of U.S. citizenship (birth certificate) or alien registration card
- Colorado ID card or driver's license (some other documents may be required)
(Married applicants must also submit the above for their spouses.)

Functional Qualification Criteria

According to Medicaid standards, applicants must "need assistance" with some or all of the following:

-Activities of Daily Living (ADL); getting out of bed; bowel and bladder care, mobility, transferring, eating, and bathing
- Basic Instrumental ADL (meal preparation, housework, laundry, shopping)
- Supportive Services (managing medicine, appointments, money, arranging for services, using the phone)

Contact the county social Services department to learn the location of the Options for Long Term Care agency serving your county or at these agencies. Submit the application form ULTC 100.2. It must be approved by the Options for Long Term Care agency.

Financial Qualification Criteria (Partial List)

- Monthly Income less than $1911
- Resources amounting to less than $2000 (couples $3000)

Exempt resources:

- Home in which applicant, spouse or dependent child resides; or to which applicant intends to return with an equity value of less than $500,000.
- One car
- Personal (clothing and furniture) belongings
- Term life insurance
- Irrevocable burial policy

Resources which count:

- Checking and savings accounts
- Stocks, bonds, investments, annuities
- Rental property/land, vacation homes
- Recreational vehicles
- Whole life insurance and revocable burial policies

If a married applicant has more than $2000 in resources, the spouse may be eligible for spousal protection, but may need to spend down resources. An applicant with more than $1911 in monthly income may need a Medicaid Qualifying Trust.