Medicaid, the national health care program that serves needy residents in each state, provides low-cost or free health care for Americans with limited income and few resources who can’t afford health insurance.
In Virginia, over a quarter of a million elderly, blind and disabled residents receive essential health care services through the state Medicaid program administered by the Department of Medical Assistance Services. The benefits provided under the program include doctor and specialist visits, inpatient, outpatient and emergency hospital care, prescriptions, lab tests and X-rays, preventive services and long-term nursing home care.
Qualifying for Medicaid
Suffolk residents can qualify for Virginia Medicaid long-term care services if they have no more than $2,313 in monthly income per individual and $2,000 in assets if single or $4,000 if married and both spouses apply. Applicants must also be U.S. citizens or legal immigrants and aged 65 or older or aged 64 or younger and disabled.
When a married applicant’s spouse doesn’t apply, their income is disregarded. If the applicant is over the income and asset limits, they may become eligible for coverage after the calculation of living and resource allowances, which protect their spouse from impoverishment. As mandated by federal law, a non-applicant spouse may be entitled to up to $3,160.50 of an applicant’s monthly income and up to $126,420 of the couple’s jointly owned assets.
Virginia Medicaid also has a spend-down provision that may help applicants who meet all the eligibility requirements except for income. Those who qualify are given a spend-down liability figure from Medicaid, and when this amount has been spent on allowable medical expenses, the applicant receives up to six months of health care coverage. Acceptable expenses may include physician, dental and hospital bills, prescriptions, health insurance premiums and certain medical supplies.
Applying for Medicaid
Seniors can apply for Medical Assistance online, by phone at (855) 242-8282 or in person at the Suffolk Department of Social Services office located at 135 Hall Avenue, Suite B.
Commonwealth Coordinated Care Plus waiver
Medicaid-eligible Suffolk residents who require long-term care services but prefer to stay in their home or a community setting such as an assisted living facility can apply for the Commonwealth Coordinated Care Plus waiver. Medicaid offers this waiver program to reduce nursing home admissions and the cost of long-term care. Those who qualify for the program are enrolled in their choice of approved managed care plans that provide all-inclusive medical and long-term care. Along with the benefits provided through regular Virginia Medicaid, CCC Plus participants receive case management and a range of other support services to meet their care needs such as:
- Relocation assistance to move from a nursing facility
- Personal care
- Nursing care
- Assistive technologies
- Medical equipment
- Prescriptions
- Medical transportation
Suffolk residents who apply for Virginia Medicaid for long-term care and are aged 65 or older are enrolled in the CCC Plus program automatically if they qualify. Those who apply should have a monthly income at or below 300% of the federal benefit rate, which is currently $2,313, and assets worth $2,000 or less.
To learn more about the program or schedule a screening assessment, senior residents of Suffolk can contact the
CCC Plus enrollment helpline at (844) 374-9159.