Tip – To qualify for Medicaid, a person must meet Medicaid’s health,
income and asset eligibility requirements.
Medicaid is a federal program administered by the Idaho Department of Health and Welfare (IDHW). The focus of this tip is Medicaid eligibility for seniors, age 65 and over, needing long-term care. For those that qualify, Medicaid will help pay for care provided to seniors in skilled-nursing facilities, assisted-living facilities, adult foster care, and home-based services for seniors in their homes.
To qualify for Medicaid, a person must meet Medicaid’s health, income, and asset eligibility requirements:
To determine if a senior meets the health requirement, a nurse from IDHW does an evaluation of the senior’s need for assistance with their activities of daily living.
To determine if a senior meets the income requirement, you look to see if their monthly income exceeds Medicaid’s income limit. In 2022 to qualify for Medicaid, the senior’s monthly income cannot exceed $2,543 a month. If their income exceeds this, they may set up a Qualified Income Trust, also known as a Miller Trust, and divert some of their income to the Trust to reduce their income thereby qualifying them for Medicaid. The Trust funds can only be used to pay for longterm care or medical expenses incurred by the senior. The Trust must be irrevocable and any Trust funds remaining in the Trust at the person’s death, must be paid to estate recovery.
To determine if a senior meets the asset requirement you look at their countable assets. In 2022, a single person’s countable asset limit is $2,000. The value of the senior’s home, one vehicle, and a prepaid funeral are not counted toward the asset limit. If a couple is applying for Medicaid, the asset limit is $3,000. For a couple with a spouse receiving long-term care and the other one remaining in their home, the asset limit for the applicant is $2,000 and the asset limit for the senior remaining in their home is $137,400.
If a senior is over the asset limit, the excess funds cannot be given away but may be spent down. For example, some excess money can be used to pay off their mortgage, repair their home, upgrade their vehicle, or prepay their funeral.
There is a lot of confusion about how Medicaid works. Here are two facts that you need to understand:
• First, if a senior qualifies for Medicaid, their monthly income is paid to the long-term care provider or their care. The difference between the senior’s income and the cost of their care each month is aid by Medicaid. The senior is allowed to keep a modest personal needs allowance each month.
• Second, long-term care paid by Medicaid is a loan. It reminds me of my student loan from law school. When I was in school, I borrowed money. When I graduated from school, I received a letter stating that it was time to start paying back the loan. Similarly, Medicaid helps pay for a senior’s care during their lifetime. When the senior dies, Estate Recovery will send a letter that the money paid by Medicaid for their care must be paid back out of their estate. For a couple, the letter is not sent until the passing of the second member of the couple.
Applying for Medicaid can be a complicated process. You may want to consider consulting an attorney familiar with Medicaid rules.
View our “Senior’s Guide to a Well-Planned Future” on our website! Packer Elder Care Law – with you for life!
Tom Packer is an Elder Law Attorney serving all Southeast Idaho. As part of his law practice, Tom offers Life Care Planning to deal with the challenges created by long-term illness, disability and incapacity. If you have a question about a Senior’s legal, financial or healthcare needs, please call us.