Am I Eligible for Medicaid?
There are several types of recipient groups that may qualify for Medicaid in Indiana, but this post discusses the eligibility requirements for those aged, blind or disabled.
Medicaid is a government program that pays necessary medical costs for needy persons. It can help pay for nursing facility services if you meet the categorical and financial eligibility requirements. The Medicaid laws help protect the income and resources of the “at home” spouse of the nursing home resident.
You must be aged 65 or older, blind, or disabled.
Income is based on the applicant and his/her spouse. It includes earned income (such as wages from a job) and unearned income (such as Social Security Disability). The income is calculated before taxes (your gross income).
For 2019, the Special Income Limit (SIL) for an applicant is $2,313. This number changes each year in January. Being above the SIL disqualifies a person from Medicaid benefits. However, there is a provision called a Qualified Income Trust (or Miller Trust) that allows a person to qualify for Medicaid benefits despite being above the SIL.
For a single person, you can have $2,000 in countable assets. For a married couple who are both receiving nursing home care, they can have $3,000 in countable assets. You cannot have any more than the allowable amount by the first of each month in order to remain qualified for Medicaid.
There are both countable and exempt resources. Countable resources include things like cash, bank accounts, stocks, bonds, mutual funds, CDs, cash surrender value of life insurance, retirement accounts, negotiable loans, and revocable trusts. Exempt resources include things like your home (so long as you, your spouse, or dependent child lives there or you are reasonably expected to return home), household goods, personal possessions, one motor vehicle, prepaid funeral trust, burial plots, income-producing real estate and certain retirement accounts.
Gifts and Transfer Penalties
You cannot make gifts over a combined total of $1,200 each year without being penalized. The transfer penalty period means that Medicaid will not cover your nursing home expenses for a certain period of time. There can be penalties if you make a transfer within the five-year look back period. Medicaid will look back five years to determine if you have made any transfers. A transfer occurs when you give property for less than fair market value. For example, if you give away real estate or add a person’s name to the title, Medicaid will consider this a transfer penalty.
Even if you are not eligible for Medicaid when you enter the nursing home, you may find that your personal resources run out quickly, and you need Medicaid. This happens to many people so you may want to consider choosing a nursing home that is certified by Medicaid, in case you later need that program’s help.
Our attorneys can assist getting you or your loved one eligible for Medicaid if it looks like nursing home care is imminent. By careful planning, you can help preserve your assets rather than paying them down with nursing home costs.