A medical specialist (nurse/social worker) in your state must evaluate your needs and decide if you need long-term care services. Usually, the specialist will make the decision based in part on whether you need assistance performing certain activities of daily living (ADL), such as:
- Using the toilet
- Transferring to or from a bed or chair
- Caring for incontinence
Good To Know
If you do not meet Medicaid’s functional eligibility criteria, Medicaid will not cover long-term care services, regardless of financial eligibility. But, if you meet the general and financial requirements for eligibility, Medicaid will still cover other services such as doctor visits and prescription drugs.