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Long-term care from Medicaid is changing

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Almost half of U.S. states provide Medicaid long-term care benefits through managed care. There are 13 states that require older adults to get their care that way.

The latest annual survey of state Medicaid programs by the Kaiser Family Foundation shows that four out of five states are increasing home care benefits. Sixteen states are using Medicaid dollars to provide housing services.

The two trends of moving toward home-based and managed care are changing long-term services and support under Medicaid. When Medicaid first started in 1965, nursing homes were where long-term benefits were paid. Home and community assistance, though, is where the benefits have shifted over the past 10 years. A decision by the Supreme Court required the changes, consumers demanded the change and federal waiver programs allowed states to have the flexibility to make them. The government has even allowed some states to provide those benefits to those in some assisted living facilities.

In 2013, the long-term supports and services programs of Medicaid spent more on community- and home-based services than it did on nursing home care. That's the first time this has happened. Over the last two years, four out of five states plan to expand, or already have expanded, their community- and home-based care programs so that older adults and young people with disabilities can receive home care instead of nursing home care.

How will this affect long-term care insurance policy holders? If there comes a time when the cost of long-term care insurance is simply too much, then it's possible that some older adults may qualify for Medicaid and receive the home- and community-based care they need instead of nursing home care. An attorney can answer your questions on the varying types of long-term care.

Source: Forbes, "Long-Term Care Is Increasingly Becoming Managed Care At Home," Howard Gleckman, Oct. 21, 2016

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