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Long Term Care Guide

Nursing Facility Program

An individual applying for the Nursing Facility Program must be a Delaware resident and must be willing to enter a nursing facility and accept Medicaid coverage. To apply for this program, contact the Central Intake Unit at 1-866-940-8963.

If in a nursing facility, a Medicaid resident may keep $44.00 of his monthly income. The rest of his income must be paid to the facility unless an amount has been protected for

  1. health insurance premiums, 
  2. medically necessary medical equipment and services not covered by Medicaid (e.g. eye glasses, dentures, hearing aids..) and/or 
  3. the needs of a community spouse under the Spousal Impoverishment provision.

If a patient in a Medicaid enrolled nursing facility runs out of private funds and converts to Medicaid payment, the nursing facility cannot discharge him if there is an available Medicaid certified bed.

Federal law prohibits nursing facilities from charging Medicaid residents or their families for items and/or services that are covered by Medicaid.

Nursing facilities which accept Medicaid cannot ask Medicaid residents for contributions as a condition of admission or charge fees to supplement the Medicaid rate.

Nursing facilities must provide a list of what items and services are included in the basic Medicaid rate and what items or services would require an extra charge. At the time of the Medicaid application interview, each applicant is given a list of what Medicaid pays for and what the nursing facility is required to supply.

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