Medicaid is a joint federal and state program that provides health coverage or nursing home coverage to certain categories of low-asset, low-income people, including children, pregnant women, parents of eligible children, people with disabilities and elderly needing nursing home care. As it relates to the elderly, qualifying for Medicaid is based upon three primary criteria. Increased care must be "medically necessary," which means that a physician must opine that more significant care, such as placement in a nursing home is needed. Secondly, an individual must not directly receive more than the allowable amount each month in income. For calendar year 2014, an individual cannot receive more than $2,163 in gross income per month. Lastly, there is an asset test, in which an individual is not allowed to have more than $2,000 in assets in their name at the time a Medicaid application is submitted. If an individual is married, the non-institutionalized spouse may have up to $117,240 in his or her name. Please note, there are several exceptions to this general rule.
Under current laws there are several permissible and legally responsible methods and strategies that are permitted by the government, which, when put into action, may assist an individual in qualifying for the program. One should not assume that they will not qualify if they do not meet the income and asset test, on its face. If you have questions on eligibility criteria, we would be pleased to discuss your personal situation.