Nursing & Skilled Nursing Facilities

Nursing facilities provide 24-hour care for individuals who need nursing or skilled nursing care. Medicaid helps with the cost of care in nursing facilities, but you must be medically and financially eligible for care in a nursing facility.

Medicaid may pay up to the full facility cost depending on your resources and income. To find out if you or your spouse qualifies for Medicaid, you will need to complete an application online or pickup one at your local HHS office. 

Back to top

Eligibility

To get Medicaid, the spouse in the medical facility must be age 65 or older, blind or disabled.

Medicaid is a health insurance program for certain groups of people based on income levels. In addition to meeting certain income levels, you need to be in eligibility groups before you can be considered for Medicaid. 

  • Apply even if you or your child already has health coverage. You could be eligible for lower-cost or free coverage.
  • Families that include immigrants can apply. You can apply for your child even if you aren’t eligible for coverage. Applying won’t affect your immigration status or chances of becoming a permanent resident or citizen
Back to top

How to Apply

To apply for any Medicaid program, you'll need:

  • Social Security Numbers (or document numbers for any legal immigrants who need insurance)
  • Employer and income information for everyone in your family (for example, from paystubs, W-2 forms, or wage and tax statements)
  • Policy numbers for any current health insurance
  • Information about any job-related health insurance available to your family

We ask about income and other information to let you know what coverage you qualify for and if you can get any help paying for it. We’ll keep all the information you provide private and secure, as required by law.

Apply by Mail

To apply for Nursing Facility Medicaid benefits please complete the Application for Health Coverage, write NURSING FACILITY MEDICAID on top of page 1, and mail, fax or email to the HHS – Centralized Facility Eligibility Unit at:

Imaging Center 1
Iowa Department of Health and Human Services
417 E Kanesville Blvd
Council Bluffs, IA 51503

FAX: 515-564-4040
Email: facilities@hhs.iowa.gov 

Back to top Back to top

Nursing Home Compare

This is a web-based portal administered by the Centers for Medicare and Medicaid Services (CMS) that provides detailed information about every Medicare and Medicaid-certified nursing home in the country and allows consumers to compare information about nursing homes. 

Use this information along with other information that you gather about nursing home facilities to help you make choices for you and your family. Nursing Home Compare is run by Medicare.

Nursing Facility and Skilled Nursing Facility Medicaid Resources

Back to top

Income Limits

The income of the spouse in the medical facility cannot exceed three (3x) times the monthly Supplemental Security Income (SSI) cash benefit for Medicaid to help pay the cost of care.

Back to top

Allowed Spending

The spouse in the medical facility can keep $50 of monthly income for personal needs. If the spouse in the facility earns money, they can also keep an additional $65 per month. HHS worker will determine if income from the spouse in the facility can be given to the spouse at home and dependent relatives living with the spouse to help them pay for their living expenses.

Back to top

Protecting Your Resources & Income

Medicaid can help married couples pay the cost of a spouse's care in a medical facility. These policies apply only if you or your spouse plan to stay, or have stayed, in a hospital, nursing facility or other medical facility for 30 consecutive days or more.

What things owned and the money saved by the couple that can be kept for the spouse at home depends on the couples' total combined resources as of the first day of the month the spouse entered the medical facility. All resources must be listed on the Medicaid application. HHS will determine which resources are countable to determine eligibility, and then split the amount between the spouse in the facility and the spouse at home.

The spouse at home can keep:

  • Half of the total resources, or $31,584* whichever is greater,
  • But no more than $157,920*.

The amount of resources kept by the spouse at home may be increased by a court order or by an appeal decision.

To be eligible for Medicaid long-term care coverage, the applicant cannot have more than $2,000 after resources are split between the spouses.

Does it matter whose name the income is in?

In most cases, when income is in the name of one individual, HHS considers the income belongs to that individual. If the income is in the names of both spouses, HHS considers one half belongs to each spouse. If there is trust property, the income shall be considered according to the trust document. The income of each spouse must be recorded by HHS and any changes in income of either spouse must be reported to your local HHS office within 10 days of the change.

* These amounts are indexed for inflation and change when the federal government releases the annual inflation amount.

Back to top