2014 Medicaid Income Limit For Home Care
Single
Person receiving home care: $809 (+$20 exemption)
Couple both receiving home care: $1,192
(+$20 exemption)
*Individuals who exceed these limits may be eligible under the Surplus Income Program
(giving it to Medicaid). Surplus income (over $809) is contributed to the cost of care, unless a 'Pooled Income Trust"
is established. A "Pooled Income Trust" can shelter income so that it may be used for expenses not covered
by the Medicaid program.
**NEW Married person option - if married and only
one is applying for Medicaid home care - couple may be permitted to keep up to $2,931 of their combined income each
month (this will require an analysis of the couples monthly income).
2014 Medicaid Income
Limit For Nursing Home
$50 per month. All surplus income must be given to
the nursing home, unless there is a well spouse living in the community who may be allowed to retain a portion of their institutionalized
spouses income.
2014 Medicaid Resource Limit For Home Care
Single Person:
$14,550
Couple, both on Medicaid home care: $21,450
**New
Limit for well spouse - well non-applicant spouse may be permitted to keep $74,820 (protected from Medicaid claim)
- this will require an analysis of the couples total assets.
Exempt Resources
- Pre-paid
funeral (no limit on value) is exempt: must be in a special contract with the funeral home;
- Car and Personal
Effects are exempt;
- Home remains exempt as long as the applicant or their spouse contine to reside in the home (max.
home value of $814,000) *(must be your primary residence).
*While exempt for eligibility
purposes, a home may be subject to claims or liens by Medicaid, unless proper planning is put in place prior to the
death of the Medicaid recipient.
** Note: Placing your home in a "Living Revocable Trusts" will not
prevent Medicaid from placing a lien on the home should a person need to receive nursing home Medicaid coverage.
- Retirement
Accounts (IRA-401K) of the applicant and the applicant's spouse. The applicant's retirement accounts must all be paying
out the minimum allowable distribution. (note: income from these accounts is not exempt and will be considered
countable income)
Exempt Income
Certain income is not counted for eligibility
purposes.
- Restitution payments from Nazi persecution
- Income diverted into an approved "Pooled
Income Trust" (home care only)
Transfer Penalties for gifting your assets apply
to nursing home care only
There are only transfer penalties imposed for nursing home coverage, there are no penalties
for community home care services. Therefore, you may transfer your assets this month and become Medicaid eligible the next
month.
2014 Spousal Allowances
The non-applicant spouse is permitted
to retain the following amounts when their spouse enters a nursing home with Medicaid coverage:
Well spouse Income
: $2,931 per month from their combined income -- if this amount is exceeded, then Medicaid may request monthly
income contributions from the well spouse;
Well Spouse Resources: $117,240 (approximate - maximum) --
if this amount is exceeded, then Medicaid may seek reimbursement from the well spouse holding the money.
Medicaid Estate Recovery Rights
Medicaid always retains the right to seek repayment for all
services rendered to a Medicaid applicant from their probate estate; they may also seek reimbursement from a legally responsible
relative (spouse). Therefore, it is important to try not to leave any assets in the applicant's name that might go through
probate upon their passing. Me
Pharmacy Coverage Under Medicaid
Once on
Medicaid, all pharmacy coverage will be handled by "Medicare Part D". Medicare Part D is a prescription drug
benefit available to everyone with Medicare. It has special importance to people with Medicare and New York State
Medicaid because Medicare Part D replaces Medicaid in paying for most of your prescription drugs.
Under
the Medicare Part D prescription benefit almost all of your drugs costs will be paid for by Medicare instead
of Medicaid. You will get prescription drug coverage from Medicare and pay a small Medicare copayment
for each prescription. If you currently receive NYS Medicaid and you do not join a Medicare prescription drug plan, you may
lose all your NYS Medicaid benefits.
When you become eligible for both Medicare and Medicaid you will automatically
be assigned to a Medicare Prescription Drug Plan to make sure you don't miss a day of coverage. You can also enroll in a plan
of your own choosing that may better meet your prescription drug needs. Information about available plans and the “Medicare
& You” handbook is available from Medicare. Be sure to read this information to understand all the changes.
For
more information, click on or call:
- Medicare
1-800-MEDICARE
(1-800-633-4227)
TTY users should call 1-877-486-2048
Or for free personalized health
insurance counseling contact:
