Medicaid Where Assets Don’t Matter

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I recently had the opportunity to help two clients who were in despair about lack of health care coverage.  One was a young single mother of a disabled child, the other a retiree widow.  The young mom told me that her child’s Supplemental Security Income (SSI, a federal low-income payment) had been canceled due to her income as a teacher, thereby terminating his Medicaid that automatically comes with any SSI payment.  The older lady explained that she had Medicare but that her $950 retirement income was not enough to cover the medical expenses not covered by Medicare.  I was pleased to describe the following Medicaid programs that allowed them to get coverage for those medical expenses.
Disabled Child Living at Home Medicaid.  This Medicaid program covers severely disabled children under age 18 who require regular assistance with at least two (2) activities of daily living (ADLs) – eating, bathing, dressing, toileting or walking.  Children who are not eligible for other Medicaid programs because the income or assets of their parents are too high may be eligible for Medicaid through the Disabled Children Living at Home category of eligibility.  A child must meet all the following eligibility criteria:

(i)   The child is under 18 years of age and determined to be disabled using Social Security disability rules.

(ii)  Requires a level of care at home that is typically provided in a hospital or nursing facility or intermediate care facility (including an intermediate care facility for the mentally retarded);

(iii)  Can be provided safe and appropriate care in the family home;

(iv)  As an individual, does not have income or assets in his or her name in excess of the current standards for a child living in an institution ($2,250 monthly income and $2,000 assets in the child’s name); and

(v)  Does not incur a cost at home to the Medicaid Program that exceeds the cost Medicaid would pay if the child were in an institution.

Qualified Medicare BeneficiaryA Mississippi resident who is Medicare-eligible and whose income is below $1,055 (as an individual, $1,404 for a couple) is eligible for this Medicaid program.  Medicaid will act as supplemental insurance to Medicare, paying the monthly Medicare Part B premium as well as other Medicare deductibles and co-payments for the individual that are not covered by Medicare.  There is no limit on assets the recipient can own to be eligible for this coverage.
Specified Low-Income Medicare Beneficiary (SLMB).   Similar to QMB, an individual who is Medicare-eligible and whose income is below $1,256 (as an individual, $1,674 as a couple) is eligible for this Medicaid program.  Medicaid will pay the monthly Medicare Part B premium (usually $134 per month) only for the individual.
If we can assist you and your loved ones, please contact one of the experienced Medicaid planning attorneys at Courtney Elder Law Associates. We will be happy to answer your questions and help you through the process.