Medicaid Eligibility in Colorado

The cost of long-term care nationwide is beyond the means of many families and with nearly 70% of Americans over the age of 65 needing some form of extended care, the question isn’t how do you avoid it, the question is how do you pay for it. With the average cost of nursing home care in Colorado at $8,600 per month (in 2022) and an average stay of 2 ½ years, you should expect to need more than $250,000 to cover your long-term care expenses.
Double that for couples! And contrary to what most people believe, Medicare does not pay for long-term care.

How will you pay for this care? Many people turn to Medicaid to fund their long-term care plan. Medicaid eligibility requirements in Colorado, as well as all states, are complex and subtly confusing and don’t expect the county Medicaid eligibility office to be on your side or even understand the complexities and subtleties.

Most seniors in the US are eligible for and enroll in Medicare for their healthcare needs. However, many people are unaware that in order to qualify for long-term care expenses, you must apply separately to Medicaid. This is worth stressing. Medicare does not pay for long-term care. The information in this article is geared towards seniors and long-term care Medicaid assistance.

Medicaid is a state managed program that uses federal and state funds in order to serve financially disadvantaged citizens with health care. However, before Medicaid pays for your care you will need to exhaust all other available resources. Because the program is run by the state and funded with federal resources, the eligibility requirements are more complicated than you might think. It’s not as easy and straight forward as applying for Medicare.

Medical Medicaid Eligibility in Colorado

To qualify for Medicaid long-term care benefits, in most cases you must be over 65 and require a nursing home level of care. That means that you must be assessed by a qualified and approved contractor of the county and officially determined to be unable to perform at least two Activities of Daily Living (ADLs).
They are: bathing and showering, continence, transfers, dressing, mobility, and feeding.

Even this relatively clear and defined requirement for eligibility for Medicaid in Colorado points to the difficulty of navigating Medicaid for long-term care. It is possible that someone could be able to perform all of the ADLs and still require long-term care supported by Medicaid. Someone with early dementia may be capable of eating, but forget to eat.

If you apply for long-term care assistance with Medicaid unaware of the program’s more subtle rules and regulations, it can cost you significant time and money. At a minimum, you might be required to re-apply after having been denied, extending the process by several months. At worst, applying at the wrong time without proper planning could cost you financially. This is why it is a good idea to have experienced professionals help you navigate Medicaid eligibility in Colorado.

Financial Medicaid Eligibility in Colorado

In addition to the medical qualifications for eligibility, an individual applying must meet two financial requirements. Medicaid looks at resources as either income or assets.

Income Eligibility

An individual must have a monthly income less than $2,523 (in 2022) to be eligible. All income sources count including wages, alimony, pensions, SSDI, SSI, benefits, IRA withdrawals, and dividends. A spouse’s income is not counted.

Asset Eligibility

You can have up to $2,000 in countable assets. This includes cash value of insurance, checking/savings, investments, retirement accounts, extra vehicles, etc.
Your primary residence, one vehicle, and personal property are exempt.

Qualifying for Medicaid when over the limits

It is a misconception that you must spend all resources to $2,000. Spend-down is only one strategy — others include paying off mortgage, home improvements, etc.

Because long-term care is expensive, many applicants exceed the limits but still cannot afford care. An elder law attorney can help.

Some Common Medicaid Planning Strategies

Income Planning Strategies

Qualified Income Trusts / Miller Trusts
Spousal Income Transfers
Income Spend Down

Asset Planning Strategies

Irrevocable Funeral Trusts
Annuities
Medicaid Asset Protection Trusts
Asset Spend Down

Being unaware of the complicated requirements for eligibility can lead to costly and irreversible mistakes. The best way to access Medicaid while keeping your financial legacy is to find an experienced elder law attorney.

Call us today to start your Medicaid Eligibility planning.

Learn more…

Colorado Medicaid Eligibility for Long Term Care

Long Term Care Colorado Medicaid

Activities of Daily Living Checklists

Medicaid Planning Strategies

FAQ About Medicaid Planning

Colorado’s Medicaid Recovery Program

Medicaid Law: LTC Insurance

Why Not to Avoid the 5-Year Lookback

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