There are asset limits and income thresholds for Medicaid eligibility to pay for care at home or in a nursing home.  These figures change from year to year, and the numbers for 2017 are explained below.
Home and Community-Based Services (HCBS) Waiver Programs.  Mississippi has obtained federal waivers to use Medicaid funds to offer services in “home and community-based” programs designed to help recipients avoid institutionalization. These include:  (1) Elderly and Disabled Waiver, which provides respite, adult day care, meals, homemaker and other services for older persons with deficits in at least 3 of the activities of daily living; (2) Physically Handicapped (Independent Living) Waiver, which provides personal care attendant services to physically disabled persons; (3) Intellectually Disabled/Developmentally Disabled (ID/DD) Waiver, which provides “day-habilitation”, respite care, attendant care, and speech/physical/occupational therapies to persons who would, without such services, require the level of care in an Intermediate Care Facility for the Mentally Retarded; (4) Assisted Living Waiver, which provides homemaker, attendant care, medication supervision, social and recreational therapies, transportation and other services to residents of personal care homes and other congregate living facilities who would otherwise require placement in a nursing facility; and (5) Traumatic Brain Injury Waiver, which provides services to persons with traumatic brain or spinal cord injuries necessary to help them avoid institutionalization.  There are other eligibility criteria, services and population limitations on these groups.  The monthly income limit for these groups is generally the nursing home income limit ($2,205 in 2017) for an individual.  The resource limit is $4,000 and liberalized resource and “spousal impoverishment” rules apply (see following section).  There is a Medicaid transfer penalty for these groups.
Long Term Care (or Nursing Home) Group.  This coverage pays nursing home costs in excess of the Medicaid recipient’s monthly share of cost.  A single Medicaid applicant may have monthly countable income of up to $2,205 (2017) and countable assets of up to $4,000 to qualify for Medicaid for LTC.  Under “spousal impoverishment” rules for married applicants, the at-home spouse (“community spouse” or CS) may keep all of his/her own separate income, plus enough of the applicant’s income to get the CS’s income up to $3,022.50  per month (the “monthly maintenance needs allowance”) (2017) if the CS’s separate income is less than this amount.  The CS may own separate countable resources of up to $120,900 (the “community spouse resource allowance”).  Assets may be assigned from the nursing home spouse to the community spouse to achieve these levels.  In addition, the applicant (nursing home spouse) may have separate income of up to $2,205 and separate countable assets of up to $4,000.  The separate income (Social Security, etc.) of the applicant spouse that is not assigned to the CS as part of the monthly maintenance needs allowance  must be applied to pay nursing home cost as the applicant’s “share of cost”, but the community spouse’s income and assets need not be spent for this care. Medicaid transfer penalties are imposed for uncompensated transfers of resources by the applicant or the applicant’s spouse.
There are many misconceptions about Medicaid eligibility for nursing home care.  Medicaid will pay nursing home costs for persons who are disabled and whose “countable” income and assets are under certain limits.  While these limits are low, a number of assets are excluded in determining “countable” assets and income.  A number of assets are not counted when determining eligibility for Medicaid.  The entire value of the residence up to $560,000 of equity (unless it is in a revocable living trust), all household furnishings, up to two automobiles, based on use, and various other assets are not counted toward the asset limit.
If you or your family member needs help navigating the Medicaid maze, Contact Us or call us today at 601-987-3000.