Resources for Kūpuna

Medicaid

·       Medicaid is Hawaii State Medical Assistance

·       The Department of Human Services (DHS) runs the program

·       You have to qualify by having limited income and assets. For a single person;

o   Gross Monthly Income in 2015 has to be less than $1,150 per month 

o   Assets less than $2,000

o   This program will cover medical costs like copays for doctor’s visits, hospitalization but long term care is separate

·       Medicaid includes a long-term care assistance program for those needing long-term care and are at an “intermediate” care level – this means that your doctor has said you need require intermittent skilled nursing, daily skilled nursing assessment and 24-hour supervision. The skilled nursing services and daily skilled nursing assessments must be provided by professional nurses – RNs or LPNs or have significant impairment in your activities of daily living. (Bathing, dressing, ambulating, transferring, eating and continence)

o   There is not a limit on income-  the individual going into the care facility receives $50.00 per month spending money and if single can only have $2,000 in assets 

o   Couples can have up to $119,220 in assets.

o   For single individuals the value of the home over $828,000 will be counted as an asset

o   There is a five year look-back period to establish if anything of value was transferred at an unfair market value to qualify for Medicaid

o   Medicaid regulations can change, it is better that you plan for your long term care needs so that you can have the care given where you want it to be

·       Medicaid is done mostly through managed care plans.  On Oahu our QUEST Integration plans are:

o   Aloha Care

o   HMSA 

o   Kaiser

o   Ohana

o   United HealthCare

·       An individual can have both Medicare and Medicaid at the same time.