Nursing Homes and Qualifying for Medicaid
It can be overwhelming to make the decision to move mom or dad into a nursing home. There are always countless details associated with the transition, including Medicaid coverage. State laws vary and it’s important to not underestimate those smallest details; otherwise, you could find it difficult, if not impossible, to secure Medicaid coverage. While the state laws vary, there are across the board rules for Medicaid coverage.
Cash Considerations in Qualifications
The first important element of the cash limitations is that a nursing home resident who is seeking Medicaid benefits must have no more than $2000 in assets. Even then, this number can change from year to year. There are also rules that affect the spouse who is not in a nursing home facility. The community spouse, as he or she is referred to in these instances, is limited to owning just one half of the joint assets. Those asset dollar figures can change from year to year – and they usually do based on the economy and inflation.
It’s referred to as the “community spouse resource allowance”. It’s the maximum amount that a community spouse can retain without having to go through legal channels.
In Ohio, if you are 65 or older, blind, or disabled, and you need long-term care in a nursing home, your income must be at or below 300% of the SSI Federal Benefit Rate. This equates to around $2,163 per month in 2014. Also, Ohioans who currently receive SSI benefits have already qualified for Medicaid coverage.
There are instances that you may still qualify for Medicaid coverage if your income is above that limit. Ohio is unique in that those who are age sixty-five and older, who are blind or disabled have the option of using unpaid medical bills, premiums, or nursing facility bills as part of their “spend down” process. This can help qualify them for Medicaid. To better understand those details, a qualified Ohio estate planning lawyer can help walk you through that important process. The spend down process can be difficult to navigate, so it’s important to understand those intricacies.
Assets that are Exempt
There are assets that aren’t applicable for figuring those numbers and include:
- Your clothing, the furniture in your home and your jewelry
- A car
- The home owned by the applicant – provided it’s in the same state the applicant is seeking Medicaid. There is one crucial element in this exemption: In some states, the home will not be considered a countable asset for Medicaid eligibility purposes as long as the nursing home resident intends to return home; in other states, the nursing home resident must prove a likelihood of returning home.
- Prepaid funeral plans and some life insurance policies.
- Assets that are considered “inaccessible”
As always, you should consult with an elder care or estate planning lawyer to ensure your legal bases are covered. That’s especially important since the laws change nearly annually. Have questions? Contact our team of experienced Medicaid lawyers today.