Elderly, Blind, Disabled, Long Term Care Medicaid Services

Medicaid

You may qualify for Medicaid if you meet the financial eligibility requirements and are age 65 or older, blind or disabled and those who are United States citizens or legal immigrants.  Eligibility is based on assets and income.  

For more information:  

 

Medicaid Purchase Plan (MAPP)

The Medicaid Purchase Plan offers those with disabilities who are working or interested in working, the opportunity for health care coverage through the WI Medicaid Program.  A premium may be required depending on the individual’s income.  Eligibility is based on assets and income.  

For more information:             

 

Medicare Savings Program (MSP)

Medicare Savings Program are for those receiving Medicare (A & B) benefits with limited countable income and assets.  Those eligible may have some or all of their out-of-pocket costs paid for by MSP.  Eligibility is based on assets and income. 

These programs include: 

  • Qualified Medicare Beneficiary (QMB)
    • Medicaid pays Medicare Parts A & B/deductibles & co-insurance
  • Specified Low-Income Medicare Beneficiary (SLMB)
    • Medicaid pays Medicare Part B premium
  • Specified Low-Income Medicare Beneficiary Plus (SLMB+)
    • Medicaid pays Medicare Part B premium
  

Medicaid Deductible Plans

Those who meet all program rules, except the income limit rule and have high medical bills, may be eligible for a Medicaid Deductible Plan.  The deductible amount will be determined based on a 6-month time-period.  Great River’s Consortium will determine how much an individual’s monthly income is above the limit and that amount will be multiplied by 6 (for the total deductible amount).  Unpaid and recently paid medical or remedial expenses can be used to meet your deductible.  Once the deductible has been met, Medicaid will pay for covered services until the end of the 6-month period.

 

Long Term Care Medicaid Services

Community Waivers

The Medicaid Community Waivers Plan helps those who are elderly, blind or have a disability to continue living in their own home or within the community rather than a nursing home or institution. 

If eligible for Community Waivers, depending on income, you may have to pay some of the medical costs known as a “cost-share”.  This is a monthly amount.  Eligibility is based on assets and income. 

Nursing Homes/Institutions

For Medicaid purposes, "institution” means medical institution.  Medical institutions include, but are not limited to: skilled nursing facilities/nursing homes, intermediate care institutions for mental disease (IMD) and hospitals.  A resident of an institution includes an individual:  residing in a medical institution for 30 or more consecutive days, or is likely to reside in a medical institution for 30 or more consecutive days, as attested to by the medical institution. 

If eligible for Institutional Medicaid, you will be responsible to pay towards your care known as a patient liability, this amount will depend on your income.  Eligibility is based on assets and income.  

For current income and asset limits: