Medicaid Policy Updates Impacting In-Home Care

Medicaid Policy Updates Impacting In-Home Care

Families that help a loved one apply for Medicaid benefits aren’t usually aware of the existence of a manual containing Medicaid eligibility rules. The Bridge’s Eligibility Manual contains pages and pages of policy that impact a person filing for Medicaid. When talking about Medicaid benefits for older persons, an October 1, 2015 update impacts persons who haven’t even considered filing for Medicaid benefits. But, if a person does apply for such benefits within five years of paying for in-home care they need to be concerned about this policy change.

When it comes to assisted living and nursing home Medicaid eligibility, the Medicaid program rightfully will deny benefits or penalize someone who gave away their assets just to attain eligibility. But most of us don’t conduct ourselves in fear of what the Medicaid manual will say when we may never need benefits. But, the October 1, 2015 change should cause concern for anyone that may need financial assistance for assisted living or skilled nursing care within five years of paying for in home-care.

The policy change infers that anyone providing in-home care to a person, even a professional care-giving company, needs a contract that complies with Medicaid policy to avoid the payments being classified as divestment. This will never matter for someone who doesn’t apply for government benefits. But for those who do, a penalty for divestment within five years of applying for benefits will be assessed. This will delay benefit eligibility, cost applicants money they likely don’t have, and impose a great amount of stress on families.

If a family member is getting paid to care for a loved one or a third-party is hired to provide care then they should make sure to have a Medicaid-complaint contract before any money is exchanged. The policy contained in BEM 405 details the requirements of personal care contracts and home care contracts. Tax reporting and withholding implications as to family caregivers receiving income for care must also be considered and handled appropriately. The policy also requires that someone needing care get a “prescription” from their physician detailing the type of care needed and that such care would keep them out of assisted or nursing home facilities.

I have seen families go above and beyond for loved ones to keep them out of skilled care as long as possible. So, I’m always dismayed to hear when this caring family is then faced with penalties they cannot pay or denial of benefits. Becoming educated on Medicaid policy now can save your family financial and emotional stress later.


Cunningham Dalman, PC publishes this web site and its component parts to inform users about our firm, our attorneys and general new developments in the law. The web site and blogs are not intended as legal advice on any matter. There are many factors that may affect your situation. You should not act or refrain from acting because of information found here without first seeking appropriate legal or other professional advice from someone who is familiar with your particular circumstances.

In the operation of this web site and our blogs, we do not intend to create an attorney-client relationship with you and no such relationship shall be created by your use of this web site. Such a relationship can only be established to the extent an attorney at Cunningham Dalman, PC expressly agrees to undertake the relationship. Please do not communicate to us any information you regard as confidential unless and until we have established a formal attorney-client relationship with you. Any information you send to us before we establish an attorney client relationship may not be privileged or confidential. Information you send to us over the Internet may not be secure.

Our Practice Areas
Our Practice Areas

Recent Posts


Cunningham Dalman P.C.
PO Box 1767
321 Settlers Road
Holland, MI 49422-1767

Google Map


Scroll to Top

Tell Us How We Can Help You

Send us a quick message or call us at 616.392.1821!

Seminar Registration

Fill in the form below to reserve your spot today for each person attending. If you have any questions, please call the office at 616.392.1821.

Call Now Button