Disability

Medicaid Letters: Income and Medicaid Resources

What are resources?

    Resources are different from income. Resources include cash, bank accounts, stocks, bonds, IRAs, and property. Your regular paychecks, Social Security, or Child Support payments are not resources.

What is a resource for purposes of Medicaid?

    Resources include cash on hand, bank accounts, IRA’s, certificates of deposit, the cash value of life insurance policies, stocks, bonds, etc.

What does Medicaid not consider a resource?

    – a burial fund and burial space

    – a homestead (but see below)

    – clothing and personal effects

    – household furniture and appliances

    – tools and equipment necessary for employment

What about a vehicle?

    Vehicles are not considered a resource if they are needed for a person’s medical care, work or for operating a business.

What does it mean to be “federally related?”

    If you meet one of the following standards, you are eligible for Medicaid because you are in a “federally related” category:

    1. children under 21
    2. adults over 65
    3. blind or disabled
    4. families with children under 18 where one parent is absent, deceased, disabled or out of work

The resource and income limits are much more generous for federally related categories, so you should get federally related if you can.

What are the income and resource levels for people who are “federally related?“

Combined Income/Resource Standard Table

                                                                            Income Standard                                          Resource Standard

Household Size                                                           Monthly

        1                                                                              $ 692                                                           $ 4150
        2                                                                                 900                                                              5400
        3                                                                               1017                                                              6100
        4                                                                               1025                                                              6150
        5                                                                               1034                                                              6200
        6                                                                               1134                                                              6800
        7                                                                               1275                                                              7650
        8                                                                               1417                                                              8500

each additional person                                                      142                                                                850

Who can get Medicaid when they are not “federally related”?

    You do not have to be federally related to receive LIF (Low Income Family Medicaid).

    To be eligible for Medicaid as a LIF family, applicants must be either:

    1. One or two-parent families with children under the age of 21,

    2. Children under the age of 21 not living with a caretaker  relative, or

    3. Pregnant women

    Another category of eligibility where you do not have to be federally related is known as Singles and Childless Couples (S/CC) Medicaid. To be categorically eligible for S/CC, applicants must be:

    a. Single individuals and childless couples who are not certified blind or disabled; and
    b. Between the ages of 21 and 64

    If you are categorically eligible for MA under LIF or S/CC, you must then check to see if you are financially eligible for MA as well. The financial guidelines are not as generous as for the federally-related groups. If you need more information on these guidelines, call our office.

Why is it important to be federally related?

    Federally related applicants can have more resources and still be eligible for Medicaid. For example, while persons receiving Public Assistance can have $2,000 in resources, Medicaid resource limits are much higher. (See above chart) In addition, federally related applicants who are over income can get a spenddown.

Whose resources count?

    For federally related clients, the resources of a legally responsible relative in the household (spouse or parent when a child is under 21) count unless the relative refuses to make them available. In such cases they will not count, and DSS can file a support petition in Family Court.

    For non-federally related clients, the resources of a legally responsible relative living in the same household are counted whether they are available or not.

What happens if assets are transferred?

    There is no rule on transfers of assets made on or after October 1, 1989, unless the applicant is institutionalized. “Istitutionalized” includes:

    – a person in a nursing home

    – a hospitalized person getting care at nursing home level

    – a person receiving CASA services who would otherwise be institutionalized in a skilled nursing or intermediate care facility

    If the applicant is in an institution, a transfer of assets (including a home) for less than market value, within 36 months of application, could result in a denial of benefits.

    The application could be granted if the denial based on a transfer of assets would cause an undue hardship. This exception does not apply if the transfer is made to a relative.

Can a home be transferred to family members and not be considered transfer of an asset?

    Yes, if it is transferred to:

        – to a spouse

        – to a child under 21 or to a blind or disabled child of any age

        – to a brother or sister who has an equity interest in the house and who lived there for at least a year before the institutionalization

        – to a child, if the child had been living with the parent for at least two years before the parent moved to an institution and the child provided care during that time which allowed the parent to remain at home.

Are other transfers of assets permitted?

    Yes. However, we do not advise clients on estate planning or transfers of assets. We recommend that this be done by a private attorney or Legal Services for the Elderly (853-3087).