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Many people are unaware that there are two kinds of Medicaid in New York:  

Community Medicaid and Institutional (Nursing Home) Medicaid.  

It’s important to understand the differences.

 

Institutional Medicaid

Institutional Medicaid is for persons who require long-term custodial care in a skilled nursing facility.  The program pays all the costs of the Nursing Home, as well as medical care.

 

Community Medicaid

Community Medicaid is for those who can be cared for safely at home or in an assisted living facility.  The typical Community Medicaid recipient is someone who needs assistance with performing activities of daily living, such as bathing, toileting, dressing, transferring, and eating.  

Community Medicaid includes medical care, as well as other benefits such as Adult Day Care, transportation to and from the doctor, and many other special programs.

If you have Medicaid, you do not have to give up your Medicare and you will probably want to have both.  

Different Applications

The two programs have different eligibility requirements, the main one being that Institutional Medicaid has a 5-year “look back,” and Community Medicaid has no “look back.”

I’ll discuss the “look back” in another video.

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