You may have made it through your working years without giving Medicaid eligibility a second thought if you were fortunate enough to be covered under an employer-sponsored or privately purchased health insurance policy. As a senior, however, you may find that eligibility for Medicaid is crucial to help cover the high cost of long-term care. Eligibility for Medicaid depends, in large part, on your income and countable resources. With that in mind, the Grand Forks Medicaid planning attorneys at German Law explain what counts as income and countable resources for Medicaid eligibility in North Dakota.
Why Might I Need to Qualify for Medicaid as a Senior?
When you enter your retirement years, you stand close to a 70 percent chance of needing some type of long-term care (LTC) services before the end of your life. If you are married, your spouse shares the same odds. If either of you ends up in nursing home care, the cost of that care could put your retirement nest egg at substantial risk unless you can easily afford to cover that cost out of pocket. Nationwide, the average cost of a year in LTC for 2021 was over $100,000. North Dakota residents paid noticeably more at just over $150,000, on average, for that same year of LTC.
The high cost of LTC is problematic because neither Medicare nor most health insurance policies will cover LTC expenses. If you did not purchase a separate LTC insurance policy well ahead of time, you will be forced to pay out of pocket for your LTC expenses or qualify for Medicaid. Medicaid is a healthcare program that is primarily funded by the federal government; however, it is administered by individual states. As such, the eligibility requirements can vary somewhat from state to state. Because Medicaid is a “needs-based” program though, all states impose income and asset limits.
What Counts as Income for Medicaid Eligibility?
To qualify for Medicaid your monthly income cannot exceed the applicable income limit which varies by Medicaid category and changes each year. For 2022, however, the income limit for an individual applicant applying for Medicaid for the aged, blind, and disabled in North Dakota was just $940 per month. For a married couple if both spouses are applying the limits was $1267 per month. Almost all “income” counts, including cash gifts, employment wages, alimony payments, pension payments, Social Security Disability Income, Social Security Income, IRA withdrawals, and stock dividends. Veteran’s benefits also count as income except benefits paid under the VA Aid and Attendance and Homebound programs. If only one spouse applies for Institutional Medicaid or a Medicaid Waiver, only the income of the applicant is counted. In addition, the non-applicant spouse may be entitled to a Minimum Monthly Maintenance Needs Allowance (MMMNA) to prevent spousal impoverishment. In 2022, the MMMNA in North Dakota is $2,550 / month.
What Counts as Countable Resources for Medicaid Eligibility?
To qualify for Medicaid as a senior, your countable assets must not exceed $3,000 if you are applying as an individual or $6,000 if married and both spouses are applying. Certain assets are considered exempt, meaning they do not count toward the income limit. Exempt assets in North Dakota include:
- Your home with an equity limit of $636,000 if you live in the home or have the intent to return to the home.
- An automobile
- An irrevocable burial trust
- Personal belongings
If you are married, all assets of both spouses count regardless of the long-term care Medicaid program for which you are applying. The spousal impoverishment rules, however, the non-applicant spouse of an Institutional Medicaid or Waiver applicant is entitled to a Community Spouse Resource Allowance (CSRA). In 2022, the community spouse (the non-applicant spouse) could retain 50 percent of the couple’s assets, up to a maximum of $137,400.
Understanding what assets will count and what assets are exempt is imperative when planning for the possibility that you will need to qualify for Medicaid. Simply transferring countable resources in anticipation of applying for Medicaid will not work. Medicaid employs a five-year look-back period that effectively discounts any asset transfers for less than fair market value completed within the five-year period prior to your application.
Contact Grand Forks Medicaid Planning Attorneys
Please join us for an upcoming FREE seminar. If you have additional questions or concerns about Medicaid planning in North Dakota, contact the Grand Forks Medicaid planning attorneys at German Law by calling 701-738-0060 to schedule an appointment.
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