Medicaid is a program that entitles individuals who meet certain income and asset criteria to benefits for Chronic Medicaid or Community Medicaid. Chronic Medicaid is care that is provided in a skilled nursing facility, whereas Community Medicaid is care that is provided in an individual’s home by a home health aide. In 2017, Medicaid applicants may have up to $14,850.00 in resources to qualify for Chronic Medicaid. A Medicaid applicant may also have retirement accounts, such as IRAs, as long as the applicant is taking the minimum monthly distributions. In addition, a pre-paid burial account is an exempt asset.
An individual seeking qualification for Chronic Medicaid benefits may have a maximum of $14,850 in countable assets and an income of no more than $50.00 per month. All other income must be allocated to his or her cost of care. If an individual has more than the required income level, he or she must have medical expenses that exceed the income overage.
If one spouse requires care and the other spouse is healthy and can maintain independence in their home or community, he or she is considered to be a “community spouse.” According to federal guidelines, a community spouse may retain a maximum monthly income of $3,022.50 and a maximum total of $120,900.00 in countable assets. A community spouse’s home is an excluded asset if they live in and the value of their home equity does not exceed $560,000.
The Community Medicaid program is another option that is available. This is the Medicaid program that will pay for care in an individual’s home. The asset rules for Community Medicaid are the same as Chronic Medicaid. However, the income rules are different. For Community Medicaid, an applicant’s spouse may retain $845.00 in monthly income. However, any excess income should be placed in a Pooled Income Trust so that the additional income may be used to pay other expenses such as utilities that an applicant may have.
Medicaid pays for the largest share of long-term care services, but only if the individual meets the eligibility requirements. The Medicaid application and eligibility professionals at P&P Medicaid Consulting, Inc. assists Nassau County, Suffolk County, and Queens residents in preparing applications for Medicaid eligibility, while taking advantage of programs and planning options that will protect their income and assets. For more information or to schedule a consultation, call our Long Island, New York Medicaid consulting office at (516) 541-4770.