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10 Ways to Pay for Care: Medicaid and Medicare
Navigating Medicaid: How the Aged and Disabled Waiver Helps Seniors Get the Care They Deserve
By Brooke Baker, RN, Co-Owner, Legacy Navigation
Let’s be honest—navigating Medicaid is overwhelming. For most seniors and families, the process feels impossible: complex forms, confusing rules, and endless misinformation. That’s exactly why my partner Jessica and I started Legacy Navigation over six years ago.
We’re a team of clinical experts and certified Medicaid planners, serving families across Idaho, Washington, Oregon, Nevada, California, and Arizona. We come from hospice and home health backgrounds, so we understand what it means to walk with families through life’s hardest transitions. Our mission is simple: to help seniors get the care they need—without losing everything they’ve worked for.
What Is the Aged and Disabled Waiver?
The Aged and Disabled (A&D) Waiver is a state-run, federally funded program that helps seniors (65+) and individuals with disabilities receive care at home or in the community instead of in a hospital or nursing facility.
This is not a handout program—it’s an entitlement benefit. You’ve already paid into it through years of work and taxes. Unlike traditional Medicaid, the A&D Waiver is designed to support independence, not impoverishment.
Who Qualifies?
To qualify, you must:
- Be 65 or older, or disabled by Social Security standards
- Require a higher level of care (for example, help with daily activities)
- Lack the funds to pay privately for the full cost of care
Even if you’ve saved money or own a home, you may still qualify. Many people assume they don’t meet Medicaid’s limits—but that’s often not true. Every state has unique rules, and there are legal, ethical tools to help bridge the gap between your income and care costs.
What Does the Waiver Cover?
The A&D Waiver covers a wide range of services to help you stay safely cared for at home or move into the right level of care when needed. These can include:
- In-home care and personal assistance
- Adult day programs
- Respite care for family caregivers
- Home modifications or equipment
- Assisted living, memory care, or skilled nursing coverage when necessary
In short: if it helps you remain safe, supported, and independent, the waiver likely helps pay for it.
Overcoming the “I Don’t Qualify” Myth
We hear this every day:
“I make too much money.”
“I get VA income.”
“Someone told me I don’t qualify.”
Here’s the truth: if your care needs exceed your income, you may still qualify. Each state offers tools to help bridge the gap.
For example:
- In Idaho, we can use a Miller Trust (also called a Qualified Income Trust) to help you qualify.
- In Washington, if care costs are higher than your income, you’re automatically a candidate.
We help families in multiple states understand and navigate these rules, so they can access care and protect what they’ve earned.
Protecting Your Spouse and Assets
One of the biggest fears we hear is:
“Do I have to get divorced so my spouse can get Medicaid?”
Absolutely not. In fact, that’s both illegal and unnecessary. Medicaid has special spousal protection rules that allow us to move income and assets to the community spouse, keeping them financially stable while getting care for their partner.
We also use asset preservation tools such as:
- Gifting and promissory notes
- Personal care contracts (to pay family caregivers legally and ethically)
- Deeding strategies to preserve home equity
- Prepaid funeral and life insurance arrangements
- Reverse mortgages when appropriate
Every situation is unique—but in nearly every case, we can help families protect their resources while qualifying for care.
Common Medicaid Myths
Let’s clear up a few big misunderstandings:
- ❌ “Medicare will pay for my long-term care.”
→ Medicare only covers short-term rehab or skilled nursing, not ongoing care or assisted living. - ❌ “The nursing home will figure it out.”
→ They might help with a basic Medicaid application—but not with asset protection or planning. - ❌ “Social Security will cover my care.”
→ Most Social Security checks barely cover basic living expenses. - ❌ “My family can just take care of me.”
→ Many family members can’t leave work to provide full-time care. Medicaid can fund professional help, easing that burden.
Here Every Step of the Way
Medicaid’s Aged and Disabled Waiver can be life-changing—but only if you know how to access it. It’s there to ensure that seniors and those with disabilities can receive quality care without losing their financial security.
At Legacy Navigation, we guide families step-by-step—helping them apply, qualify, and preserve what matters most.
If you have questions or think you might qualify, reach out to our team. We’re here to help.
Understanding Medicare’s Limits
Many people assume Medicare will cover long-term care—but that’s not the case. Medicare pays for medical needs like durable medical equipment (DME)—walkers, oxygen, and similar items—as well as short-term home health services. However, it does not cover in-home caregiving, assisted living, or long-term stays in senior living communities. Knowing these limits is key to planning ahead for future care needs.
If you want to continue this conversation or need guidance, I’m here.
Brooke Baker
If you want to continue this conversation or need guidance, I’m here.
Jessica Young
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Our country is entering a new chapter, one we have never seen before… over 100 million people are 50 years of age or older, and the need for care is going to be more and more prevalent. We are dreaming of a nation where aging and care are understood and become part of our normal conversations with family.
To make this a reality, we need your help!