Medicaid has helped millions of seniors, people with disabilities, pregnant women, and children get the health care coverage they need. The program is jointly funded by the federal and state governments, designed to help financially eligible people get the medical and long-term care. Whether you need financial aid now, you’re planning ahead for the future, or you’re researching on behalf of a loved one, there are certain key rules you should know about the program’s eligibility requirements. If the applicant resides in Washington state or Idaho, make sure you understand the following Medicaid eligibility facts.
1) How to qualify financially.
One of the main eligibility requirements is financial, since Medicaid is designed for people with low incomes who would otherwise be unable to afford medical care. To qualify, your annual household income (before taxes) must fall below a certain threshold depending on the number of people who live with you.
2) How to qualify in general.
You must also meet several general requirements before you can be eligible for Medicaid. For one, you can only apply to receive benefits in your state of residence (or, in other words, you cannot apply for benefits from another state). You must also be a United States national, citizen, permanent resident, or legal alien.
3) How to qualify medically.
Of course, to qualify for Medicaid you must also be in need of health care assistance. To that end, you must fit into at least one of the following categories:
- You are pregnant.
- You are blind.
- You are the parent or caretaker of a dependent child or children under the age of 19.
- You have a disability, or a family member in your household has a disability.
- You are aged 65 years or older.
4) The look-back period.
Although one of the main eligibility requirements involves your income, Medicaid also applies limits to the value of your assets. Many people wonder if they can simply transfer assets—to make financial gifts to your children, for example—in order to qualify. Due to Medicaid’s five year “look-back” period, this isn’t the most viable plan of action. The program will count assets transferred during the five year period before your application, and they will usually still count towards the valuation of your estate. An estate planning attorney can provide you with more effective ways to work around this rule.
5) How your spouse affects your eligibility.
If you live with a spouse, known formally as the “community spouse,” how will that affect Medicaid’s income and asset rules? Thanks to the “Spousal Impoverishment” rules, your spouse can keep a certain number of assets and income. In Idaho the current maximum value for spousal assets is $120,900, and in Washington the maximum ranges from $54,726 or 50% up to $120,900 if the spouse is institutionalized. If your spouse’s assets don’t match the minimum amount (currently $24,180 in Idaho and $54,726 in Washington), they may be able to keep some of the applicant’s resources to make up the difference. Similar rules apply to your spouse’s minimum and maximum income.
6) Asset exemptions.
Depending on your state, certain assets are exempt from the limits. That means you can keep certain types of property without counting them towards the asset totals. For instance, you are often able to keep personal effects, household goods, your home (up to a certain equity value), and one motor vehicle (under specific circumstances).
The best way to assure your Medicaid eligibility is to contact a reputable estate planning lawyer. At Estate & Long Term Care Group, we understand how overwhelming it can be to prepare an application in compliance with the program’s many complex rules. Contact us for compassionate support throughout the process. We will work hard to ensure you get the benefits you deserve.
Written by ELTC Law Group
