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The maximum income limits change dependent on the marital status of the applicant, whether a spouse is also applying for Medicaid, and the type of Medicaid for which they are applying. Nursing home Medicaid may have a different income limit than home and community based Medicaid services, and both of those may differ from the Aged, Blind and Disabled income limits. For married applicants, the 2022 asset limit for Texas MEPD is $3,000 combined between the two applicants/spouses, and the income limit is a combined $1,261 / month. These limits are used for both married couples with both spouses applying for MEPD and married couples with only one spouse applying.
If you are looking for long term care Medicaid, then you better know the current numbers. In most states, you can retain up to $2,000 as an individual and $3,000 for a married couple outside of your countable assets. There are specific rules for protecting Texas homesteads which are too complex to go into detail here. However, a Medicaid applicant’s residential homestead in Texas may be protected while they are alive if certain conditions are met, but what about the Medicaid Estate Recovery Program after the Medicaid applicant passes away? We can help you protect your home, both while you are alive as well as preserve its value for your heirs.
Talk to an Estate Planning attorney.
However, to be eligible for Medicaid nursing home care, the patient must have very limited income and very few financial assets . If your doctor prescribes home health services like nursing or therapy services in your plan of care for a particular medical condition, Medicaid will cover those. You do not need to meet the nursing home level of care to qualify for home health services. However, because these Medicaid-funded home health services are related to a doctor’s plan of care for a particular medical condition, they are generally offered on a short-term basis.
The individual must have limited financial resources and a documented need for care. Texas offers its residents several Medicaid programs, some of which are entitlements and others have limited enrollment. Nursing home care is an entitlement for all Texas residents that require it and meet the program’s financial criteria .
Moving Into A Senior Living Community
There is a different set of numbers that impact the Medicaid applicant’s (or their spouse’s) assets. Then, Id recommend visiting your respective states government website and apply through the Health Insurance Marketplace or with your state Medicaid agency. When applying for a specific Medicaid policy, its important to ensure that coverage is for Medicaid-certified nursing homes.
The maximum Community Spousal Protected Amount increased from $123,600 to $126,420. Just as with the minimum, this does not mean that the spouse of a nursing home Medicaid applicant can keep $126,420. Remember it only means the spouse can keep $126,420 if the couple’s total combined counted resources are worth $252,840 or more. In that situation the spouse could keep $126,420, the spouse in the nursing home could keep $2,000, and the rest ($124,420) would have to be spent down in ways that do not result in a penalty. January 1st is when the government changes certain numbers that determine eligibility for Texas nursing home and long term care Medicaid benefits.
How Do I Spend Down Assets For Medicaid
For long-term care services via the Regular Medicaid program, a functional need with the activities of daily living is required, but a NFLOC is not necessarily required. Upon becoming eligible for Medicaid, all of the applicants income must be used to pay for the nursing home where the applicant resides. However, you may be allowed to keep a monthly allowance and a deduction for medical needs, such as private health insurance. The amount of the allowance varies depending on your living arrangements, type of nursing facility, and state rules.
If your loved one is over the income limit, and they do not have a properly created and administered Miller Trust then you will not be able to prove eligibility for Medicaid benefits. The Community First Choice Program is an entitlement program that, in addition to personal care, provides in-home support, such as meal preparation, medical alert services, and chore services. Medicaid rules exempt small whole life insurance policies from the calculation of assets if the policy’s face value is less than $1,500.
HHS works with federally qualified health clinics, medical associations, community partners and local governments to help clients find the health care they need. Aging and Disability Resource Centers can help Texans find personal care, nursing care, help at home and other long-term care services. 1) STAR+PLUS Waiver – This is a limited enrollment, managed care program that covers assisted living, adult foster care, and many in-home supports to help beneficiaries avoid nursing home placement. Further complicating eligibility is that the criteria vary with marital status and that Texas offers multiple pathways towards eligibility. The second change is an increase in the Medicaid Applicant's gross monthly income limit. In 2018 a Medicaid applicant was only allowed to have $2,250 per month in gross monthly income (using the government’s definition of “income” which may be a little different from what most people consider to be “income”).
Furthermore, many states allow the use of Miller Trusts or Qualified Income Trusts to help persons who cannot afford their care costs to become income eligible for Medicaid. There are also Medicaid planning professionals that employ other complicated techniques to help persons become eligible. Finally, candidates can take advantage of spousal protection laws that allow income to be allocated to a non-applicant spouse.
Certain other expenses may be deducted if the person meets program policy requirements. Live in a Medicaid-contracted long-term care facility for at least 30 consecutive days. Separately identifiable burial funds of $1,500 or more, if irrevocable, for the applicant and the applicant’s spouse.
Beginning January 1, 2019, a nursing home resident will be allowed to have $2,313 per month in grossmonthly “income”. Medicaid coverage amounts may vary from state to state, depending on the demand for nursing home care coverage. For example, the average cost of nursing home care in the state of California is on the higher end at $304 a day, compared to Texas at $165. This greatly impacts the coverage and benefits you can receive from Medicaid to offset the costs of nursing home care. For qualifying individuals, Medicaid picks up most of the tab for nursing home care, paying an average of 45 percent to 65 percent.
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