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Is acceptance into the Medicaid program guaranteed?

Many Americans, including some Texas residents, are a bit unclear on the details of government programs centrally involved in the administration of long-term care for elderly persons.

For example, it is certainly not uncommon for people in many instances to lack a full understanding of the differences between the Medicare and Medicaid programs that assist eligible Americans in various ways.

Some people believe, for example, that the Medicare program is the government initiative most closely tied to nursing home care.

That is incorrect. It is in fact Medicaid that comes into play for most people who will need to spend some time in a nursing home. As noted by a Medicaid planning primer written by a national group of certified public accountants, Medicaid "is the single largest payer of nursing home bills in America."

As the American Institute of Certified Public Accountants (AICPA) further notes, Medicaid is often the sole lifeline for persons having limited assets who cannot afford to pay for nursing care with their own resources.

It flatly surprises many people that Medicaid eligibility is not assured in every case. Rather, persons who seek long-term care assistance through the program must first satisfy a number of requirements related to income thresholds and other matters.

It thus behooves individuals and families who see the potential for Medicaid participation on the horizon to engage in purposeful planning well before the need arises.

The reasons for that are many. Astute advance planning can enable the sheltering of some assets that will legally make them exempt from Medicaid calculations, for example.

The rules, timing considerations and planning strategies applicable to Medicaid can be quite complex. Owing to that complexity, the AICPA pointedly advises persons seeking information on the program to consult as early as practicable with an experienced elder law attorney.

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