Home Care Medicaid Eligibility

Date: 11:18:2022 | 171 article views
By: Burner Law Group, P.C.

Brittni Sullivan is an attorney at Burner Law Group, P.C. She joined the firm in January 2013 as a legal intern while she was still in law school. Since 2015, Brittni has been concentrating her practice in the areas of Estate Planning and Medicaid as well as Guardianship.

Question: If I receive home-care Medicaid, will the state take my income?

Answer: Community Medicaid, also known as home-care Medicaid, is a program that pays for a variety of medical services that enable individuals to stay in their homes. Importantly, Medicaid pays for home-care aides who assist with activities of daily living (e.g. dressing, bathing, toileting, and feeding). Medicaid recognizes that to stay in the community, such individuals likely need to use all their income.

To be eligible for Medicaid, one must meet the income limits (there is also a $16,800 asset limit, but income is the focus of this article). The current Medicaid income limits for Community Medicaid are $875/month for an individual and $1,284/month for a couple. Applicants who are over 65, disabled, or blind are entitled to an extra $20.00 of monthly income.

Without further planning, income in excess of this monthly limit would be paid to the Department of Social Services as a contribution toward the care received. To capture this excess income, one must create a Pooled Income Trust. Pooled Income Trusts are established and managed by non-profit organizations for the benefit of people with disabilities. Medicaid applicants can deposit excess income into a Pooled Income Trust each month. Then the Medicaid recipient can submit bills for household expenses which will draw from the excess income deposited. Any bills submitted must be in the name of the Medicaid recipient. Bills in the name of the recipient’s spouse, for example, cannot be paid from the trust funds. Additionally, the balance of any funds remaining in the trust upon the death of the beneficiary go to the Pooled Income Trust. So it is important that the beneficiary timely submit their monthly bills and not let money accumulate in the trust.

For most clients it would be a struggle to continue to live in their homes based on Medicaid’s monthly income allowance of $875.00. Moreover, most people would not be able to afford the high cost of home health care aides without Community Medicaid. The Pooled Income Trust is an invaluable tool that enables individuals to live comfortably in their homes and receive needed care.