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Long Term Care Medicaid:
Conditional Eligibility Requirements
Even if you already receive
Medicaid benefits, you must apply for long-term care Medicaid for
nursing home payment. You do this at your county Department of
Human Services Office.
- The Individual must be a
U.S. citizen or qualified alien.
- The individual must be a
resident of Arkansas. If the individual is coming from another
state, prior approval must be obtained from the Office of Long Term
Care, Medical Need Determination Section.
- Categorical eligibility
requires that the individual be 65 years of age or older, or;
- Blind (visual acuity of
20.200 or less, or limited visual field of 20 or less, with best
correction, or;
- Disabled (unable to engage
in sustained gainful work activity for a least 12 months as
determined by the Social Security Administration or the Medical
Review Team.)
Long Term Care Medicaid:
Financial Eligibility Requirements
There are two categories for
financial assets that are taken into account in determining an
individuals eligibility for Medicaid: income and resources
INCOME: Think of
income as the amount of money an individual receives. This would
include Social Security, Veteran's benefits, railroad retirement,
pensions, annuities, dividends, rental income, withdrawals from IRA, etc. For the year
2012, the acceptable monthly income cap is $2,094.00. The income limit usually increases at the first of each calendar year. Income of spouse and children not counted. Persons applying for the Assisted Living waiver may establish eligibility through an income trust.
RESOURCES: Resources are
countable things of value a person has ownership in. Resources include
real property, cash, checking and/or savings accounts, certificates of
deposit, promissory notes, mortgages, stocks, mutual fund shares, bonds,
trusts, automobiles, life insurance policies with a cash value,
IRA's, Revocable burial funds, etc
Resources that are not usually counted:
The Home - If the equity interest of the home is less than or equal to $525,000. If your spouse, your child under age 21, or your blind or disabled child resides in the home. If you, your spouse or a relative dependant on the home for shelter resides in the home.
One motor vehicle
Burial spaces for any member of the individual's immediate family
Prepaid irrevocable burial plans
The resource limit for the covered individual is $2,000. If you have a spouse living at home, special protection of resources are available based on total resources for you and your spouse. In 2012, the amount is between $22,728 and $113,640 based on a formula.
Individuals who exceed these
requirements might still be able to qualify by creating what is known as
a Miller's Trust. Contact your county Department of Human Services
office for more information.
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It is generally
acknowledged that long term care coverage is the glaring hole in the
safety net provided by Medicare, Medicaid and private health care
insurance. As with most insurance, the younger you are when you
enroll in a plan, the more reasonable the premiums.
Even if you enroll early, the costs of long term care insurance reflects
the staggering cost of nursing home care. Before you select a
plan, it is important to understand the cost and benefits.
Assistance in determining your options is available through SHIP, the
Senior Health Insurance Program at 1-800-224-6330.
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