Medicaid Start/Stop Rules

by Carol

I am in the process of trying to get my sister who is currently in a nursing home approved for Medicaid. The nursing home says she qualifies. If she is approved, then at a later date it is determined that she can return home with some at home health care, does her Medicaid stop? Does it just re-start if she is hospitalized again down the road, or do we have to go through the whole application approval process each time she is hospitalized?


She owns a home, however she has lived there with her boyfriend for 20 years. He is currently in the home. I am paying to maintain her home, but once she is approved for Medicaid, and it is officially determined she will not return home, I plan on having her boyfriend take over the bills on the home. Since he is very bad with money I am sure it won't take long for him to miss payments and fall in arrears. Can I just let the home go unmaintained and let the city take it for back taxes?

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Aug 19, 2010
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Medicaid qualification isn't for life
by: Gabriel Heiser

If when she returns home she is switched to HCBS (Home and Community Based Services), that is still part of Medicaid, so she can continue going back and forth. If indeed she no longer meets the medical requirements for Medicaid when she comes back home, then yes, she would have to re-apply should she need it again in the future.

In other words, qualification is not determined once and then carried forward for life.

You can get more medicaid answers at Medicaid Secrets.

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Marquette, Michigan
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