Dear Inquirer,
Medicaid is a state-run program funded by the federal government.
It helps people of modest financial means pay for long-term skilled care.
This care may take place in a nursing home, within one's own home or in an
assisted-living home setting. If your finances are limited and you are in need
of long term medical care, Medicaid may be of great help to you.
Medicaid is a "needs based" program. This means that you are entitled to
Medicaid only if your finances are limited. (Medicaid also requires that you
attain a certain level of skilled medical need before being eligible. Only the
financial requirements for nursing home placement are discussed here.) There
is a two-pronged test in determining financial eligibility: 1. How much you
make in monthly income, and 2. How much you have in assets, or resources.
1. Income.
Alaska
is an "income cap" state. To be eligible for Medicaid in Alaska you cannot
earn more than $1656 a month. If your monthly income exceeds this amount by
even $1.00 you are not eligible for the Medicaid program. So, for example,
if a person made $1000 in Social Security each month and $657 or more in
retirement income, that person is over the Medicaid income cap limit by
$1.00 and is not eligible for Medicaid!
To avoid hardship, the federal government has permitted the use of an
instrument called a Medicaid trust (sometimes called a "Miller
trust") which is authorized under 42 USC 1396p(d)(4). This is a
document that allows you to have your monthly income placed in a separate
bank account under the name of the trust, and under the control of a
separate trustee. The trustee is usually a family member or trusted friend
who handles the person's income each month. If you live in a nursing home,
all of your monthly income will go to that nursing home, except for $75
spending money for you. (This $75 is called a Personal Needs Allowance.)
If you are living in the nursing home and you have a spouse at home,
Medicaid will allow your spouse an allowance of as much as $2610 of your
income to be used as stay-at-home support. This allowance is reduced by the
amount that your spouse earns on his or her own. For example, if he or she
received $1000 per month for his or her own social security, the monthly
spousal allowance would be $1610 ($2610 minus $1000).
2. Resources. (Assets)
To be eligible for Medicaid, you cannot have more than $2000 in assets
or resources. However there are certain important exemptions. The spouse,
who is not applying for Medicaid, is entitled to a resource allowance in
the amount of $104,400. So, if you and your spouse had a joint bank account
in the amount of, let's say $103,400, your spouse could move $102,400 from
that account to a bank account solely in his or her own name. You would
then be under the $2000 resource limit, since the bank account under your
name would contain only $1000.
The value of your home up to $500,000 is not considered a resource, and is exempt.
Even if you do not have a spouse at home you can claim this exemption. You always
have a right to file a form stating your intent to return home someday.
An automobile is exempt for the Beneficiary or a member of the Beneficiary’s
household to provide necessary
transportation for the Beneficiary.
There are other exemptions that are not discussed in this general
overview of Medicaid eligibility in the state of Alaska.
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