In order to qualify for Medicaid eligibility, there are five basic requirements that must be met. These requirements go beyond income and include details such as medical necessity, residency as well as local availability.
We will touch on the different income requirements and cut off levels for eligibility.
First and foremost, age is the number one factor and should be the first thing considered before applying.
Institutional / Nursing Home Medicaid
As of the year 2020 a single individual at a minimum age of 65 years can have an income of no more than $2350 in a single month.
This also applies for nursing home Medicaid, assisted living and in-home care when it’s provided through a states HCBS waivers.
Please keep in mind This coverage of Medicaid is specifically for institutional or nursing home Medicaid.
Medicaid Income Limits
An individual receiving Medicaid may not surpass a monthly income of $2205.
If for any reason their income surpasses that amount, some planning must be done in order to create eligibility.
If an individual is married, typically the spouse’s income does not count towards the income, so it is important to maximize income protection through a monthly needs allowance.
The Medicaid office allows the community spouse to earn as much as $3022 per month.
Medicaid Asset Limits
If an individual applies to Medicaid for long-term care, they are typically allowed to keep $2000 in assets. If they are over this amount, they must spin down on care.
An important note to take into consideration is that individuals are not allowed to give gifts in any amount for a period of 60 months prior to applying for Medicaid.
There are Medicaid planning strategies that can help individuals who have assets in a higher range than $2000.
Home equity should also be taken into consideration for Medicaid asset limits.
The maximum amount one can submit for home equity and Medicaid is $560,000.
It is important to take note and understand that your home may be subject to the Medicaid repayment process if necessary.
What Are Medicaid Resource Limits?
Resources are categorized as countable and excluded for eligibility purposes.
Resource eligibility limits depend much on whether the applicant for Medicaid is married, and if an individual is applying for Medicaid with a spouse who also qualifies.
An unmarried applicant can have countable resources and a limit for an unmarried applicant up to $2000.
A married applicant who is married to someone that is in eligible has a countable resource limit that is equal to one half of the couples combined countable resources.
If a couple is married and both of which live in a nursing home and are both applying, the countable resource limit is $3000.
A couple that is married and living in a nursing home while only one qualifies the resource limit for the applying spouse’s $2000. The countable resource limit for the spouse that does not qualify or is not applying for Medicaid is unlimited.