Find Senior Care (City or Zip)
Join Now Log In
M
MaMasBoy Asked July 2013

How do I apply for Medicaid for mom when her income exceeds qualifications?

my mother receives medicare which only covers temporary home care. how do i go about applying for medicaid benefits when my mothers income exceeds qualifications for medicaid

igloo572 Jul 2013
This site has a couple of articles on how Medicare and Medicaid work and how they are different. Medicaid is an "at-need" program in which they have to be basically at poverty level for income & assets AND also must have the medical necessity for skilled services. Not all states provide at home or community services via Medicaid, so you need to find out what your state does. In many states, Medicaid is geared to paying for skilled nursing services in a NH setting.

Do you understand how Medicaid works as far as the difference in "income" and "assets". Assets by & large have to be spent down before and in order for Medicaid compliance. Assets are like savings, investments, cash value insurance or other policies with a cash value. There are exempt assets for Medicaid like a car and their home (but upon death the house becomes non-exempt and subject to possible estate recovery through each state's MERP system.)

How does your mom's "income" exceed Medicaid in her state and is the income from a guaranteed income source? This will imho make a big difference in what you can do. Say mom lives in TX and TX Medicaid has as their limit $ 2,094.00 for income. If the situation is where mom has $ 800 in SS a month and then has a fixed and guaranteed retirement of $ 2,000.00 a month, then mom has $ 2,800.00 a month in "income". Mom has already spent-down her savings, and cashed in her whole life insurance policy and has only $ 1,500.00 in the bank - so mom is OK and under the $ 2K in "assets" that is set by the state for Medicaid. The problem is she is $ 706 a mo over income limit for Medicaid ($ 2,800 - 2,094 = $ 706). No matter what mom does she is always $ 706 over each & every month for income.
What mom can do if that is her situation is establish a Miller Trust (or Guaranteed Income Trust). Miller is totally legit and done all the time. What happens basically in Miller is that her income goes into the trust each month and the trust is set up so that the beneficiary of the trust is the state medicaid program and upon her death all the $ in the trust goes to the state to offset her costs to Medicaid. Family gets no benefit from the $ in the Miller Trust. Miller is not a DIY project as it really needs to be done by an elder law attorney who know how to do it so that is works for the laws in your state and is done to be flexible and adaptable for changes in income. The key to Miller is that the income MUST BE from a guaranteed source. Mom also does need to have the medical necessity & need for skilled services too and all that aspect you have to work out with her MD's. Good luck.

ADVERTISEMENT

Ask a Question

Subscribe to
Our Newsletter