Medicaid will help pay for medically necessary nursing home care for a Medicaid eligible person in a nursing home or an Intermediate Care Facility for those with intellectual disabilities.

Long Term Care Medicaid is for those 65 or older, blind or disabled individuals or couples who have been in a hospital or nursing facility for 30 days or longer.

Nursing facilities have beds reserved for Medicaid residents, which are approved by a state agency. Medicaid will pay only for nursing care in the Medicaid-approved beds. Before admission, the nursing facility must inform the resident of his or her rights and what items and services are provided.

Medicaid recipients must use their income to pay for nursing home care. Medicaid pays the difference between the recipient's income and the nursing home rate. The recipient keeps $30 per month for personal needs not provided by the nursing home. An additional amount may be set aside for a spouse living at home or for special needs such as health insurance premiums and charges not covered by Medicaid.

What Medicaid pays for:

  • Room charge
  • All general nursing, dietary, medical and psychiatric services
  • Reusable items/equipment such as ice bags, canes, crutches, walkers and wheelchairs
  • Personal items such as shampoo, combs, razor blades, soap and lotions
  • Medical supplies such as diapers, bandages, dressings, aspirin and antacids
  • Laundry services
  • Hair trimming that is hygienic (there may be fees for permanents, hair coloring, or special styles)
  • Special dietary supplements used for tube or oral feeding, such as a supplemental high-nitrogen diet (If nutritional supplements are prescribed, they are not considered part of the six prescriptions allowable monthly)
To participate in Long Term Care, individuals must apply for Medicaid first. There is not a separate application process for Long Term Care.

Wake County Human Services does not monitor nursing homes or handle complaints about nursing home care. If you have any complaints about a facility, you may call the N.C. Division of Health Regulation at 919-844-4500 or the Long-Term Care Ombudsman at 919-558-2711.