Author: Brenton McWilliams
For a single applicant: $2,000 in countable resources
For a married couple where both spouses are receiving Medicaid benefits: $3,000 in combined countable resources
For a married couple where only one spouse is receiving Medicaid benefits: One half of the couples combined countable resources with a minimum of $25,284 and a maximum of $126,420 (2019 - Figures change annually)
Medicaid is a means-based benefit program. To receive benefits under Medicaid, individuals applying and renewing must meet certain financial criteria to qualify for benefits. One of those requirements is a limit on countable resources owned by the applicant.
There are several categories of assets which Medicaid does not consider when determining eligibility. These are noncountable resources. Everything else is a countable resource.
For a single applicant, the countable resource limit is $2,000. For married couples, the combined countable resources owned by either spouse are considered for eligibility. Where both spouses are receiving benefits, the countable resource limit is $3,000 for the couple.
The Community Spouse Resource Allowance
Where only one of the spouses is applying for or receiving Medicaid benefits, the countable resource limit is calculated based on the combined countable resources owned by the couple as of the snapshot date. To come up with the figure, the value of the combined countable resources is split in half. The countable resource limit is $25,284 if one half of the combined countable resources does not exceed $25,284 in value. If one half of the combined countable resources exceeds $25,284 then the countable resource limit is equal to one half of the combine countable resources owned by the couple up to a maximum of $126,420. This is called the community spouse resource allowance. These figures are recalculated annually based on inflation. This article uses the figures current as of 2019.
What are income and assets?
It’s important to recognize the difference between income and assets to understand the eligibility requirements. Income is money or property received by the applicant. Examples of income include social security payments, pension payments and dividends. Assets are money or property currently owned by the applicant. Examples of assets include a home, cars, stocks, and money held for over a month. According to Medicaid rules, income received by an applicant becomes an asset at the beginning of the next month.
How does someone become eligible for Medicaid?
If you or your spouse have countable resources which exceed the eligibility amounts above, how do you qualify? Medicaid wants you to spenddown your assets by paying for your medical expenses on your own until you qualify. If you give away assets to become eligible, Medicaid will impose a transfer penalty which will require you to pay your own medical expenses when you would otherwise be eligible for Medicaid. However, spending down your assets on nursing home care until you’re eligible for Medicaid is not typically the best way to become eligible. You can keep assets to supplement Medicaid benefits and preserve assets intended to be given to heirs with a planned out structured spenddown. Generally, the goal of a structured spenddown is to move assets into areas that are exempt from consideration by Medicaid.
If you need Medicaid benefits and would like to discuss how you can become eligible without losing everything you own, please call me direct at (251) 215-9275 to setup an appointment for a free consultation.