Medicaid exempt assets: What Federal and State Laws grant

by GarySpicuzza » Tue Apr 22, 2008 09:19 am

Medicaid, the State and Federal Government program pays for health services and nursing home care for the elderly in your home. This program has been designed for individuals with low income and if you have limited assets. An added advantage of Medicaid is that it also pays for some long-term care services at home.

How would you choose long-term care?

This is an important decision that you need to make. When choosing long-term care you need to plan out your health care needs in the future. How much you would pay for such care depends on the type of policy you buy. Experts say that if you have the savings for long term care you may not consider buying a policy. But, if you do not have then maybe you could consider buying one. The cost of treating chronic illness can be expensive and this is when a policy like this can be very advantageous.

Usually, LTC recipients of Medicaid are usually those who are aged or from the disabled group, but there are only a handful who receive SSI and yet opt for LTC.

What are the assets exempted under Medicaid and LTC?

There are certain Medicaid asset exemptions made by the Federal and state laws when determining eligibility. As an applicant you would first have to use all of your assets in excess of the exempt amount in order to pay the cost of nursing care facilities before you can qualify for Medicaid. If you are married, your spouse’s assets would also be combined to determine eligibility.

The following are Medicaid exempt assets:
  • A house but only when you (the applicant) are likely to return home. Your home may also be among Medicaid exemptions if your spouse, or a child under the age of 21 years or a child over the age of 21 years but disabled, or a brother/sister owning part of the house and having resided there for at least 1 year continues to live in that house.
  • Essential items like furniture, appliances etc.
  • Personal items like jewelry, clothing etc.
  • Burial plots
  • Funds for burial up to $1500 each in case you are married and $1200 if you are a single applicant.
  • A cash surrender value in a life insurance. This is possible only when the face value of the policies together is less than $1500. However, term life insurance does not have a cash surrender value and hence is totally exempt.

Related readings:

Exempt assets from Medicaid with Long Term Care insurance. (LTCi)

There are 25 states with Long Term Care Partnership Programs.

This is significant legislation as a person can now LEGALLY exempt their assets from nursing home and Medicaid spend down by simply obtaining Long Term Care insurance.

Click HERE to read Florida Statute 409.9102.

(b) Provide a mechanism to qualify for coverage of the costs of long-term care needs under Medicaid without first being required to substantially exhaust his or her assets, including a provision for the disregard of any assets in an amount equal to the insurance benefit payments that are made to or on behalf of an individual who is a beneficiary under the program.

(4) The Department of Children and Family Services, when determining eligibility for Medicaid long-term care services for an individual who is the beneficiary of an approved long-term care partnership program policy, shall reduce the total countable assets of the individual by an amount equal to the insurance benefit payments that are made to or on behalf of the individual.



States with Partnership Legislation:

Arkansas
Iowa
NorthDakota
Colorado
Maryland
Ohio
Florida
Massachusetts
Oklahoma
Georgia
Michigan
Pennsylvania
Hawaii
Missouri
Rhode Island
Idaho
Montana
Virginia
Illinois
Nebraska
Washington
New York
Indiana
Connecticut
California

Total Comments: 113

Posted: Fri Feb 10, 2012 07:12 am Post Subject: Look Back

My mother in law lives with me and spends about $2,500 dollars a month of her modest assets to assist with the cost of operating our household which includes a mortgage payment. Is this spending subject to the look back in determining her assets for eligibility for Medicaid should she need to go into a nursing home.

Posted: Fri Feb 10, 2012 07:12 am Post Subject: Look Back

My mother in law lives with me and spends about $2,500 dollars a month of her modest assets to assist with the cost of operating our household which includes a mortgage payment. Is this spending subject to the look back in determining her assets for eligibility for Medicaid should she need to go into a nursing home.

Posted: Fri Feb 10, 2012 07:12 am Post Subject: Look Back

My mother in law lives with me and spends about $2,500 dollars a month of her modest assets to assist with the cost of operating our household which includes a mortgage payment. Is this spending subject to the look back in determining her assets for eligibility for Medicaid should she need to go into a nursing home.

Posted: Fri Feb 10, 2012 07:12 am Post Subject: Look Back

My mother in law lives with me and spends about $2,500 dollars a month of her modest assets to assist with the cost of operating our household which includes a mortgage payment. Is this spending subject to the look back in determining her assets for eligibility for Medicaid should she need to go into a nursing home.

Posted: Fri Feb 10, 2012 07:27 am Post Subject: medicaid spendown

If you have a mortgage on your home and receive social security disability retirement benefits, will this disqualify you for medicaid?

Posted: Fri Feb 10, 2012 11:14 am Post Subject:

As far as I know, SSDI benefits won't be affected by a mortgage but Medicaid might. You should have a talk with your SSDI and medical advisor to clear your doubts.

Posted: Fri Feb 10, 2012 09:08 pm Post Subject:

You should have a talk with your SSDI and medical advisor to clear your doubts.


Heller's answer, like many of his others elsewhere, is both incomplete and fundamentally incorrect. We don't know anything about his background or qualifications, but by the nature of his frequent misinformation, it is dubious, to say the least. The person to speak to about qualifying for Medicaid is the Social Worker employed by your local county Welfare/Public Social Services agency who will determine your eligibility -- Social Security has nothing to do with it (even though our Social Security dollars are being stolen to pay for Medicaid benefits), and a person's "medical advisor" (whatever that is supposed to mean -- a doctor, perhaps? -- is not likely to be in a position to advise about Medicaid eligibility in any way.

Here are some facts:

Eligibility for Medicaid for Long Term Care is a two-pronged test of assets and income. A personal residence (and personal jewelry, one car, and any business property/assets) is among the major assets exempt from the spenddown test if the "confined" person "intends to return" to the home [who would not so intend?], but the residence will have a lien placed against it for mandatory asset recovery following the death of the Medicaid recipient -- this will be extended for as long a the recipient's spouse remains in the home. The amount of the mortgage payments (assuming both spouses are on title) will be divided between the confined spouse and the "community" spouse as part of each person's spenddown liability. The value of stocks, bonds, and mutual funds are all "countable" assets.

Monthly income, such as pension or retirement plan distributions, income from rental property or other passive investments, or from a "reverse annuity mortgage", cannot be "sheltered" through the purchase of annuities or life insurance, and the cash value of any cash value life insurance is also countable as an asset down to about $1500 (the average cost of cremation services).

The cash value of annuities not in the distribution phase are a protected asset -- as long as the annuity(ies) was purchased more than 60 months prior to the Medicaid application. The "value" of any money used to purchase any annuity within 60 months of applying for Medicaid will remain part of the "countable" assets of the applicant on paper, and that value, along with the value of all other countable assets, will have to be spent down to the asset retention limit (even if it requires withdrawing money from the annuity, and even if that withdrawal is subject to a surrender charge -- the surrender charge does not count toward the spenddown, it simply reduces the remaining value of the annuity).

SSDI payments end at age 65, so would not be a factor in Medicaid eligibility at or after that age. Prior to age 65, however, SSDI is simply part of a person's monthly income, which must be spent down to the $35 allowance level before Medicaid eligibility may be established for the month (assuming the community spouse also meets his/her income spenddown). At age 65, a SSDI beneficiary simply begins to collect their SS Retirement benefit (which is usually lower than their SSDI benefit), but that is INCOME, and must be counted toward the monthly spenddown.

There are many abuses in annuity sales directed toward seniors, and some agents promote annuity sales as a means of qualifying for Medicaid. For anyone considering the purchase of annuities as a way to qualify for Medicaid . . . that 60 month hurdle is a very large one to jump over. Some agents fail to discuss both the 60 month lookback period or the surrender charges in the annuity -- both of which are now violations of the NAIC Suitability in Annuity Transactions Model Regulations which were adopted in all states in 2010 or 2011 and are in effect as of January 1, 2012 in most or all states.

For more information about those regulations, visit your state's Dept of Insurance website.

Posted: Wed Feb 22, 2012 09:02 pm Post Subject: Medicaid Exemptions

My wife is in a nursing home. I own a farm and this is my only source of income. Is my farm exempt. I live in Minnesota.

Posted: Thu Feb 23, 2012 06:05 am Post Subject:

If you and your wife live in the home on the farm property, it is exempt from the Medicaid spenddown test if your wife's "intent" is to return to the home when she no longer needs to be in the nursing facility (of course, she wants to do that).

If your farming is a business, those assets (land, equipment, etc) are also protected from the spenddown test.

Posted: Mon Apr 16, 2012 07:01 pm Post Subject: medicaid

If I apply or medicaid in Indiana will I have to give up my car? My car is the only way I have of getting anywhere even to the doctor. I am 63 years old and on Social Security, I rent my apartment, I have a checking account so that social security can deposit my funds.I have no other assets

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