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What Is The Difference Between Nursing Home Medicaid And Community Medicaid?

What Is The Difference Between Nursing Home Medicaid And Community Medicaid?

Nursing home Medicaid and community Medicaid are both programs that fall under the umbrella of Medicaid, but they serve different purposes and have different eligibility requirements.

NURSING HOME MEDICAID

Nursing home Medicaid, also known as Long-Term Care Medicaid, provides coverage for individuals who require skilled nursing care or long-term care services in a nursing home facility. This program helps cover the costs of nursing home care for eligible individuals who meet the specific criteria set by their state’s Medicaid program. The eligibility criteria typically include meeting certain medical and functional requirements, as well as meeting the financial eligibility criteria, which includes an asset limit. 

 
COMMUNITY MEDICAID

Community Medicaid, also referred to as Home and Community-Based Services (HCBS) Medicaid, provides coverage for individuals who need long-term care services but wish to receive those services in their own homes or community settings rather than in a nursing home facility. Community Medicaid allows individuals to receive support services that help them remain in their homes and communities while receiving the necessary care. Services covered under community Medicaid can include personal care assistance, home health care, adult day care, respite care, and other community-based services. 

 

The main difference between nursing home Medicaid and community Medicaid lies in the setting where the care is provided. Nursing home Medicaid is designed for individuals who require care in a skilled nursing facility, while community Medicaid allows individuals to receive care and support services in their own homes or community settings. 

Understanding the key differences between Nursing Home Medicaid and Community Medicaid helps you decide which program best meets your needs, whether you require intensive care in a nursing facility or support services in your own home. Both programs are tailored to provide essential care but are designed for different environments and care situations. If you or a loved one are considering Medicaid for long-term care, consulting with a Medicaid specialist can provide clarity and assist in navigating these options effectively.