Medicaid eligibility rules are confusing, hard to understand and can seem completely random! Each Medicaid program has different eligibility requirements, and below we’ll break down three common questions asked about rules and resources. Resources are things that you own, including money, personal property and real estate. Your monthly income is not a resource and Medicaid has a different set of rules about income.
What are Medicaid Resource Limits?
Medicaid limits the amount of ‘countable resources’ you may have. Unmarried individuals may have up to $2,000 in countable resources. Married couples living together can have up to $3,000 in countable resources between them. Couples who share a household with others may have special ‘deeming’ rules applied. Most Medicaid programs have resource limits, and some do not. Expansion Medicaid, known as MAGI, has no resource limit. Adults 65 and under with income less than $1,482 per month qualify if they don’t have Medicare. Additionally, Specialized Recovery Services (SRS) has no resource limit. Individuals with certain health conditions and income below $2,382 per month qualify.
Which Resources are Countable? Which are Exempt?
In general, anything you could use to pay for health care is countable. Money in a bank account, cash in your wallet, are all countable resources. Anything that could be ‘cashed out’ is countable as well. Retirement and investment accounts, stocks and bonds, and whole-life insurance policies. Cars, trucks, motorcycles, boats, campers, ATVs, and other vehicles are countable resources. Medicaid uses the NADA Guide to value vehicles. Real estate (other than your home) is countable, and Medicaid uses the county-assessed value, or you can have the property appraised.
Medicaid does not count some resources. Your home is exempt up to a value of $603,000. Also, one vehicle used for transportation is exempt. The value of a pre-paid funeral, burial, and cemetery plot is not countable. Neither is life insurance that does not have a cash value, such as term or group life insurance. Medicaid does not count personal belonging such as furniture, clothing, computers, yard equipment, and tools, unless you use them to earn income.
My Spouse is in a Nursing Home. How Much can I Keep?
Married individuals who need long-term care have special resource rules. Often one spouse is healthy, but the other spouse needs long-term care. Medicaid calls the healthy spouse the “Community Spouse” (CS). The spouse applying for Medicaid is the “Institutionalized Spouse” (IS). Medicaid looks at the combined countable resources of the couple. The IS can have up to $2,000. Medicaid determines a Community Spouse Resource Allowance (CSRA) for the Community Spouse. The total amount the couple can have and qualify for Medicaid is the CSRA plus $2,000. The amount of the CSRA depends on how much in countable resources a married couple had at the “Snapshot Date”. When the IS entered long-term care determines the snapshot date. If the IS had a previous 30-day stay in a hospital or nursing home, the snapshot date is when that stay started. Otherwise, it is the start of the current stay. The CSRA is one-half of the couple’s combined countable resources as of the snapshot date, up to $130,380, but the CSRA can be no less than $26,076.
In simple terms, a married couple with $28,076 or less qualifies for Long-Term Care Medicaid. If a couple has more, they may still be eligible depending on what their resources were as of the snapshot date. If a married couple has more than $132,380, they will have to reduce those resources to become eligible.
We know that was a lot of information, but hopefully it gave you a quick overview and better understanding of eligibility rules. Medicaid is complex, we know you’ll have questions, and we are here for you as you plan for your future.