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Artist69 Asked November 2020

Do you have to be dirt poor to qualify for Medicaid?

My mother has no assets to her name. Only disability from Social Security and a pension from my father. I'm worried they will tell me she gets too much money each month. I have a friend who only gets 1100 from SS per month and she was turned down. This makes me think my mother probably won't qualify. Thoughts?

worriedinCali Nov 2020
The income limit for Medicaid in your state is $1469. Your friend is under the income cap, she should be eligible for Medicaid unless she actually brings in more than money than she told you. Additionally she qualifies for subsidies and credits through the ACA marketplace and can probably get insurance for little to no money.

If your mother needs LTC and is over the income limit then the bad news is that your state doesn’t allow for Miller trusts but probably has a “medically needy” pathway which allows her to spend down her excess income on her health care costs every month which then lowers her countable income & makes her eligible for Medicaid.

JoAnn29 Nov 2020
Medicaid for health, in home care or care in a Nursing home. In home care and NH care pretty much the same criteria. Health insurance criteria allows for a little more money to be on hand.

In my State I think the cap income for Medicaid in home and NH care is 2300. You are only allowed 2k in assets. You stay in your home and are allowed a car. Are you sure that your friend doesn't have money put aside. Like Savings, CDs, IRAs, stocks or bonds. If so, these may count as assets and need to be spent down before Medicaid wil, take over. $1100 is not enough to live on.

You need to call your Medicaid office and find out what the income cap is for your State. Also, how much in assets they allow. Each state is different. Please, don't take info from other people as gospel. Every situation is different so you need to talk to a Medicaid caseworker.
worriedinCali Nov 2020
For Medicaid health insurance, savings stocks bonds and IRAs are assets not income. Medicaid health insurance looks at income only not assets unless the person is apply for home & community based services (programs that pay for adult daycare, home caregivers, etc).

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mstrbill Nov 2020
There are two kinds of Medicaid, community Medicaid and long term care Medicaid. Community Medicaid benefits depend on the State you live in and typically cover medical costs that Medicare doesn't cover. For example, my father for years had community Medicaid along with Medicare so Medicaid picked up the balance of medical costs that Medicare didn't cover, and his prescription costs were very small, under $5 per prescription. Different States have different income levels for that assistance though, and if he lived in Florida instead of CT, he would not have that same coverage. So it depends on what State your mom lives in. You should be able to access the information you need as far as income limits and Medicaid benefits on her state's website. LTC Medicaid is different though, and if your mother becomes medically dependent on 24 hour nursing care, she will qualify for LTC Medicaid once her savings have been depleted. No matter what State she lives in, she can qualify for LTC Medicaid, BUT there may be different ways to go about it depending on the State and depending on what her monthly income is.

BarbBrooklyn Nov 2020
Medicaid is a joint State/Federal program. Each state has its own regs.

There are different types of Medicaid; community medicaid (medical insurance) and Nursing Home Medicaid (for long term care). There are also a myriad of Medicaid waiver programs.

There are ways around the income caps in some cases. Some cases allow you to spend down assets and income. Some allow your medical bills to be deducted from income. In some states, you can set up a pooled income trust so that excess income goes into a trust that eventually reverts to the state upon the death of the person covered.

Medicaid is a very different case if there is a "community spouse" involved.

There are a LOT of reasons why Medicaid might have been denied in the neighbor's case. She might have gifted money or property within the 5 year look back period. She might own more than one property. She might not have understood the ways enumeratd above to get her income below the limit.

Talk to a Medicaid case worker and/or an elder care attorney to get the full picture for your mother.

pixiedust Nov 2020
It depends on the state you live in, and what type of coverage you're applying for. In some cases, a person can qualify for Medicaid with something called a "spend down" - they can demonstrate that their medical expenses are so great that they agree to spend down their income on allowable expenses (each month) to then qualify for Medicaid. Each state is different. Your best bet would be to reach out to social services/human services in your county (or the county where your mom lives) and start the conversation with them. Your local Area Agency on Aging might have certified Health Insurance Counselors that would also be able to assist you.

AlvaDeer Nov 2020
Medicaid is on the same website as medicare. Rules also change in each and every state as it is a join State and Federal program. Please look up the rules in your own State and get the facts.

Bridger46146 Nov 2020
Apply and talk to Medicaid caseworker.

sjplegacy Nov 2020
Never use someone else's experience w/ Medicaid eligibility to determine your mom's qualifications. Income is a consideration but so is medical necessity. Being on SS disability may bump your mom up on the pecking order. Go ahead and apply.

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