Some Medicaid classes of assistance do not require verification, but most long-term care classes of assistance do. Verification documentation includes…
Government Bonds are debt instruments issued by a government entity. The most common form of government bond owned by a…
General Rule One vehicle of any value is exempt. If the applicant has more than one vehicle, then the most…
Another “option” that may be considered in appropriate cases is divorce. Deeming between spouses terminates when the marriage terminates. In…
MCCA includes a mechanism for increasing both the CSRA and the MMMNA in certain cases. The methods by which this…
As eligibility is being determined, if the Community Spouse’s monthly income falls below the Minimum Monthly Maintenance Needs Allowance (“MMMNA”),…
Income and resources are treated differently. Unlike resources, income is not pooled in determining eligibility; the Community Spouse’s separate income…
In Dullard v. Minnesota Department of Human Services, 529 N.W.2d 438, 443 (Minn. App. 1995), Minnesota was allowed to reevaluate…
Some couples might consider reducing the size of the marital estate by giving their resources away. Frequently this is the…
Federal law protects the healthy (or healthier) spouse of a nursing home resident. The healthier spouse is known in Medicaidland…
The following the committe report for the Medicare Catastrophic Coverage Act of 1988 (MCCA): The leading cause of financial catastrophe…
While nursing home bills accrue, the healthy or well spouse, known as the “Community Spouse,” [Note 1] struggles to identify…
Medicaid planning is discussed in more detail in subsequent chapters. Planning is the process of restructuring an estate in a…
Medicaid beneficiaries cannot “fix” eligibility by giving away resources. A transfer of resources without receipt of fair market value will…
As with the income rules, the resource defaults may be changed. First, if all of the Applicant's income has been…
A Community Spouse is entitled to a resource allowance in addition to the income allowance. 42 U.S. Code § 1396r–5(f)(1)…
As a general rule, all countable resources owned by the Institutionalized Spouse are considered available to pay his or her…
The law protects a Community Spouse with low income. It does this by diverting a portion of the applicant's income…
On the income side, there are three pathways to Medicaid eligibility for nursing home residents. First, SSI recipients are almost…
In evaluating financial eligibility for Medicaid, both monthly income and resources must be considered. The basic rule is everything having…
Categorical and medical eligibility is covered in Chapter 2. Here we begin an aerial fly-over of financial eligibility. In this…
Only those persons with a medical need are eligible for Medicaid and not all persons needing help receive Medicaid. In…
With few exceptions (such as the existence of an interstate compact), a Medicaid applicant must be a resident of the…
An applicant must be a U.S. Citizen or a legally admitted alien to receive Medicaid. 42 CFR § 435.406. In…
In addition, to establish technical eligibility for nursing home Medicaid, an applicant must be (i) a U.S. Citizen or lawfully…
Individuals who are aged (age 65 or older), blind or disabled may be entitled to Medicaid if they are medically…
The remainder of this book focuses on long-term care Medicaid. Long-term care refers to a wide range of supportive and…
The enactment of the Omnibus Budget Reconciliation Act of 1986 (OBRA 86) offered States an option for covering persons whose…
Many States provide SSP benefits with State-only dollars on a monthly basis. These payments are intended to cover such items…
With one important exception, States are required to provide Medicaid coverage to recipients of SSI. SSI, authorized under Title XVI…
The Federal Medicaid statute defines over 50 distinct population groups as being potentially eligible for States’ programs. Some groups (classes…
Medicaid was enacted in 1965, in the same legislation that created the Medicare program, the Social Security amendments of 1965…
The Medicare program (Title XVIII of the Social Security Act) provides hospital insurance (HI), also known as Part A coverage,…
What are people talking about when they say you have to "spend down" to become eligible for Medicaid? Well, it…