Medicaid 101-Answers to Your Most Frequently Asked Questions

Ben Lamm

When your elderly loved one needs long-term care, there are plenty of tough decisions that need to be made. Many families turn to Medicaid in an effort to ensure that their loved one gets the care they need. Understanding the ins and outs of Medicaid, however, can be a challenge.  By taking a look at these frequently asked questions, you’ll be more likely to successfully navigate those complex needs and make the right decision for your loved one.

What are the assets that count for Medicaid eligibility?

Any money that you have in an account, whether it’s a checking account, a savings account, or any other type of account, is an asset that counts toward Medicaid eligibility. If your family has more than one car, the second car is counted as an asset. Property that you don’t live in qualifies as an asset as well.

What assets don’t count for Medicaid eligibility?

You may keep your home and one car without needing to count them toward Medicaid eligibility. You’re also allowed to have a burial fund of up to $1,500 and a funeral agreement that pays ahead for your funeral expenses.

What is the maximum income for Medicaid eligibility?

In order to be eligible for Medicaid, you must make less than the income cap. This varies by state. In New York, for example, the income limit is $845/month for a single elderly individual over the age of 65. For other state guidelines, click here for NY, here for NJ, here for CT and here for PA guidelines.

What is considered income?

Any money that you have coming in that is available for your use is counted as income.

How much income can the nursing home resident keep?

Medicaid allows a personal needs allowance for Medicaid recipients. Most income will need to go toward paying for nursing home care, but a minimal amount may still be made available to the individual. This amount varies from state to state, for example in NJ only $35 can be kept by the nursing home resident, while in CT that amount is $60 per month.     

How far back does Medicaid look to determine eligibility?

Medicaid will check over any financial transactions that you have made in the five years before your application including the transfer of money to your children and other personal transactions. This is a why it makes sense to begin planning for long-term care well in advance of needing when possible.

Can my spouse keep any of our assets?

If your spouse plans to remain part of the community while you’re going into a nursing home, they may keep a percentage of your income in order to pay for their care and other needs. Medicaid’s goal is not to impoverish the community spouse.

Can my children keep any of my assets?

Significant transfers to your children of either property or money can disqualify you for Medicaid assistance for up to five years after the transfer. If you have a minor or disabled child who needs you to financially provide for their care, some exceptions may apply.

Can any purchases be made with my assets to reach eligibility?

Yes. You can purchase personal items, make repairs or other changes to your home, and purchase a single vehicle to transport you to and from appointments in order to reach eligibility guidelines. Personal expenses are considered a reasonable use of any funds that you have. You can also use your assets to pay for burial care. And last, you can pay a professional for assistance in applying for Medicaid.

Can I set aside some of my assets for funeral and burial expenses?

You may set aside a burial fund in the amount of $1,500 or less. You may also enter into an agreement with a funeral home to prepay for your funeral expenses in a reasonable amount.

Is there a minimum age requirement for Medicaid?

In general, Medicaid is available to individuals over 65 years of age.

Some final words of encouragement

It can be emotionally taxing to make the decisions necessary in order to prepare a family member for Medicaid. Before making those decisions, it’s particularly important to understand income guidelines and asset restrictions in order to be sure that your loved one will be able to receive the care they need as soon as possible. By working through your loved one’s finances, you can make sure that you’re ready to deal with the application when it arrives.

About the author

Ben Lamm is with Senior Planning Services, a New Jersey-based company that specializes in LTC Medicaid planning. Their Medicaid planning professionals would be happy to answer any questions you have if you or a family member are considering applying for Medicaid. Call Senior Planning Services for a free consultation at: 1-855-775-2664.

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