Colorado Gerontological Society and Senior Answers and Services
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Quick Facts - What is  Medicaid?

Medicaid is a federal and state benefit which 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), Old Age Pension (OAP), and Aid to Families with Dependent Children (AFDC), automatically receive Medicaid. Individuals 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 (which takes at least six weeks), applicants may need professional help. Both functional and financial qualification 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
(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:

- Critical Activiites of Daily Living (ADL); getting out of bed; bowel and bladder care
- Basic ADL (walking, dressing, bathing, oral hygiene, eating)
- 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 Single Entry Point or case management agency. Submit the application form ULTC 100. It must pass approval by both local officials and the Colorado Foundation for Medical Care.

Financial Qualification Criteria (Partial List)

- Monthly Income less than $1626
- 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
- Car valued below $4500 or of any value if used for medical transportation
- Personal (clothing and furniture) belongings of less than $2000 value
- Term life insurance
- Irrevocable burial policy

Resources which count:

- Checking and savings accounts
- Stocks, bonds, investments
- Rental property/land, vacation homes
- Recreational vehicals
- 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 $1536 in monthly income may need a Medicaid Qualifying Trust.

To achieve financial qualifications for Medicaid, apply to the the county Social Services department or Single Entry Point, depending on where the applicant resides.


Eileen Doherty is the Executive Director of the Colorado Gerontological Society and Senior Answers and Services. She has worked in the areas of policy, clinical practice, and education in gerontology for more than 20 years. She can be reached at 303-333-3482.







© Colorado Gerontological Society, Denver, Colorado.   For addtional information call 303.333.3482