Medicaid: Nursing Home Eligibility
Authored By: North Mississippi Rural Legal Services
|Medicaid: Nursing Home Eligibility|
To qualify for Medicaid coverage of nursing home care, an individual must by age 65 or older, blind or disabled. A physician must certify that the nursing facility level of care is needed. The nursing home must be a qualified Medicaid provider. The individual must also meet income and resource guidelines.
The income limit for 2002 for Medicaid reimbursement for nursing home care in Mississippi is $1635/month. (Note - if an individual's income exceeds $1635/month, the excess income can be placed in a trust in order to qualify the individual for Medicaid. The amount placed in trust will be paid to the State for reimbursement of Medicaid payments for nursing facility care made on behalf of the individual during his lifetime. The individual must pay all of his income to the nursing home except for amounts allowed to be deducted. These are:
Medicaid pays the difference between the patient's share and the Medicaid rate.
The income of the spouse of the nursing home resident (community spouse) does not affect eligibility for Medicaid coverage for the nursing home resident. The community spouse is allowed to receive the income of the spouse in the nursing home in an amount that will bring the community spouse's income up to $2,232/month (2002).
The spouse in the nursing home is limited to $4000.00. The "community spouse" may have resources up to $89,280 (2002).
Many resources are exempt, meaning they are excluded from the resources considered by Medicaid in its eligibility determination. The exempt resources include, among other things, the homestead of any value; income producing property if it produces a net annual return of 6% of the equity value; all household possessions; personal property valued at $5000 or less; whole life insurance with a value of $10,000 or less, per person; all term life insurance, regardless of value; two automobiles; family burial plots; a burial fund up to $6000/couple; the value of in-kind support and maintenance for most categories; a general exclusion of $50; unlimited exclusion of irrevocable burial funds. These exempt resources are not counted in the $89,280 amount that the community spouse is allowed. The community spouse is allowed an additional $89,280 in 2002.