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I live in Texas and I’ve been on Medicaid/SSI since 2013. I figured at some point they would discontinue my SSI benefits, but I would like to know if the little bit of savings I have in my bank account is safe.



I have read that to “qualify” for Medicaid, I can only have a limited amount of assets. I’ve been living in a nursing facility about a month now and I’m worried about my savings. What should I expect? Please help!

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The amount of "countable" assets you can keep varies by state, as different states' Medicaid programs have allow amounts. Medicaid itself sets the amount at $2000, but the state can opt to allow a higher amount. Our state allows the person receiving LTC Medicaid to retain an additional $8,000, so $10,000 total. I just checked, and Texas has just the regular Medicaid $2,000 limit. As Igloo said, Medicaid also allows a person to set aside money in an irrevocable funeral/burial trust, which will not count as an asset--and the amount allowed for that also varies by state.
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If you are going to be a permanent resident, then yes they will only allow you a certain amt of money. You will be asked to turn over your Social Security to offset the cost of your care. You will receive a small amt of money for your personal needs.

Medicaid health and Medicaid for LTC have different criteria. You will need to apply for Medicaid LTC.

If by SSI you mean Supplimental income, I think that will stop if you receive Medicare for LTC. You can't have both.

There should be a Social Worker at the facility who can help you understand all this. I would have a family member or friend with you when this is all explained. Office of Aging can help too.
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Medicaid is a huge “at need” type of program… everything from those Happy Healthy Teeth vans that visit grade schools via CHIP to loan outs of breast pumps for moms via WIC to paying for room&board custodial care in a NH via Medicaid LTC program.

There is also Medicaid as health insurance for those who are low/lower income. If you were / are on SSI you’ve had Medicaid as health insurance. Medicaid as health insurance is different than being on Long Term Care Medicaid where Medicaid is paying for the custodial costs for you to live in a NH. You would basically have Medicaid for both health insurance and for room&board costs. It sounds like this is your situation.

Each Medicaid program has its own eligibility rules.

For those living in a NH on LTC Medicaid the requirements by & large are you have to be “at need” medically for skilled nursing care services in a facility and “at need” financially which tends to be for an individual to be at under $2200 a mo in income (like $ you get from SSA each month or any other retirements/ pensions) and for an individual applicant a maximum of $2,000 in non exempt assets (like $ in the bank). ((A home and a car are exempt assets & I’m assuming you have neither as the rules for how those get dealt with are a whole other hot mess of issues…..)).

Yeah 2K in nonexempt asset as a maximum for LTC Medicaid. I think you need to find out exactly if a LTC Medicaid application has been done for you. The NH you are in is getting paid in some way: if you were hospitalized then went to the NH they may be paid via a rehab benefit of your health insurance. But once rehab ends often a facility will do a LTC Medicaid application on a resident’s behalf….. and the NH kinda assumes that a person on SSI & health insurance Medicaid is really poor…. and then when your financials get reviewed by the Medicaid caseworker for LTC it’s found that you actually have more assets than is allowed. If that happens then you have to do a “spend down” of the $ to get to the allowable asset limit of 2K for an individual
BUT
there has been imo a real change to the 2K maximum rules for those who qualify to be able to do an ABLE account. If you could possibly qualify for an ABLE account then you can set aside up to 14K a year in a bank account to the point of a maximum of 110K (may be 120K, I’m not sure on the max $ amount) with all of the $ in the ABLE totally being outside of ever being counted as an asset for Medicaid. ABLE are kinda new, like last 5 years or so and require you to do banking at a bank that specifically participates in your States ABLE Act banking system.

ABLE is designed for those who have a disability that stems from a childhood or early adulthood disease or event. I’m familiar with it as I was a coTrustee for a older cousin who had 1950’s era polio, so he would have qualified to do an AbLE. If the reason you have been on SSI is due to something from an event from before your 30’s, you might be able to do an ABLE. As you are in a facility and on Medicaid, you have a Medicaid caseworker, this is something that you need to clearly speak with as to your possibly doing. The Social Worker at the NH also could be helpful in all this as well. Good luck and let us know what happens as we all do learn from each other.
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igloo572 May 20, 2022
Also if you have to do a “spend down”, you can buy a funeral / burial preneed policy (state will have a limit on the value), buy something that Medicaid might not cover or Medicaid pays for really low cost versions…. Like a better wheelchair or walker, also eyeglasses, and dental work… stuff like this can be ok to use your $ in for the spend down. You just can’t gift or give $ to others, all the $ has to be for you, yourself or your needs or your care. The caseworker can go over all this w you. Good luck!
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