Medicaid for Homecare

What is Covered?

Community Medicaid is the standard health insurance that covers the majority of medical services like doctor’s appointments and hospital visits, laboratory tests, as well as prescription drugs. A majority of those in the older blind, disabled, or aged category also are covered by Medicare. For these people, Medicare functions as their primary health insurance. Medicaid is an additional insurance plan that fills in the any gaps in Medicare coverage, as well as covering services that are not provided by Medicare. If someone also has an Medicare Supplement (Medigap) policy, as well the policy will in the beginning take care of its portion and Medicaid will cover the things that remain.

Although Medicaid provides prescription medications however, those with Medicare won’t be able to have their prescriptions covered through Medicaid directly. Instead, Medicaid will pay Medicare to offer a free Medicare Part D prescription drug program for beneficiaries.

Community Medicaid with Long-Term Care is a combination of everything Community Medicaid does with the inclusion of community-based long-term care options such as home care and adult day care as well as assisted living.

 

What are the Eligibility Requirements?

Medicaid is a program that is tested for means that is designed to help people with poor incomes and limited resources. Medicaid will consider two financial categories in making a decision on eligibility: resources and income. The term “income” refers to money that is deposited regularly, like Social Security, a pension or IRA which is distributed. Resources are the assets the person applying for the loan has, such as bonds, savings, stocks and real estate, as well as an IRA which is not distributed.

In the current Medicaid income limitations to be used for Community Medicaid are $859/month for an individual, and $1267 for two people. The applicants in the elderly blind, disabled, or elderly category are eligible for 20 dispensations. In practical terms the limit for income is $879 per month for an individual and $1,287/month for couples (a couple can only get one disregard of $20).

The current limit on resources in Community Medicaid are $15,450 for an individual, and $22,800 for couples. People who aren’t seeking long-term care coverage can declare their assets but are not required to record their assets. If they are seeking coverage for long-term care have to prove their assets. Documentation for resources constitutes the sole difference between applying for regular Community Medicaid and Community Medicaid with Long-Term Care.An applicant that may eventually require long-term care should seriously think about documentation of their assets at the time of applying and then applying for the more extensive level of coverage.

If you are in need of home care for your loved ones, or assistance in navigating the system , we’re here to assist. We can assist you in completing the CDPAP( Consumer Directed Personal Assistance Program ) program. This program can help you to get money to care for the needs of your beloved one.also you will be able to keep your job , or could ask another family member to look after of your loved one who requires help.you may contact us at 347-891-6577 and we will be able to assist you for no cost .

What happens if your earnings or resources are greater than what is allowed by the Medicaid maximum?

Don’t feel discouraged if you’re income or resources are higher than what is considered to be the Medicaid limit. There are a variety of ways those with assets and income over the Medicaid limit are eligible.

Common methods used by people who have incomes that are over the Medicaid limit are able to qualify.

Here are some of the most common ways that those who earn above the Medicaid limit may be eligible:

Health Insurance Premiums

The money that is used to pay for an insurance premium for health is not taxable and therefore isn’t considered when Medicaid budgets the income of an applicant.

Pay-In and Spend-Down

The person can pay Medicaid the amount that exceeds the income limit , and then receive Medicaid benefits. Another way to obtain Medicaid coverage is by “spending down”. This is where those who are Medicaid recipient “spends down” their excess income by paying medical expenses. After they have paid the sum of their surplus income towards the expense of medical bills, Medicaid will provide coverage for any additional expenses. Spending or paying in could be a good option for those who are only barely above the limit of income.

Earned Income

Earned income gets an extremely favorable budgeting process for those who are disabled, elderly blind and elderly categories. Earned income is first given a disregard of $65. The remaining amount is divided into two. Here is an example

Sally works part-time in the local supermarket and earns $1,065 per month. In order to calculate their Medicaid planning, Medicaid will first deduct $65 from her total. Then, it will be left with the sum of $1,000. This is then, Medicaid will divide $1,000 by two. The budgeted earnings of her will be just $500.

Pooled Income Trust

The sheltering of excess income in an income trust pool is one of the most sought-after options for those who are who is above the limit of income to be eligible for Medicaid. NY State policy is that any excess income that is deposited in the trust pool (the name is derived from the way that the funds are held in the trust, although each beneficiary has their own personal account) from a disabled individual is not considered for Community Medicaid budgeting. It’s almost impossible to prove for anyone who requires long-term medical treatment. A trust for pooled income cannot be used in cash. The trust, however, can pay for bills on behalf of the person who is its beneficiary.

Holocaust Restitution Payments

Holocaust Remedies are exempt and not considered when Medicaid budgets an applicant’s earnings.

Spousal Impoverishment Allowance

Spouses of Medicaid beneficiaries who are enrolled within Managed Long-Term Care (MLTC) plans can receive a percentage of the income of their spouse in excess of a total income for the spouse and them of $3,160.50/month. This is known as the Minimum Monthly Maintenance allowance (MMMNA). In addition those who are Medicaid participant who is enrolled in MLTC can receive the Personal Needs Allowance (PNA) of $408 per month. Couples can make a monthly salary that is up to $3,568.50 and still remain in the Medicaid limit when one of them is in an Managed long-term Care (MLTC) policy.

Common ways that people have assets that are above the Medicaid limit are able to qualify.

These are the common ways that those who have resources that are greater than the Medicaid limit are eligible for:

Homestead

Generallyspeaking, real estate is a countable resource. However the applicant’s primary residence is exempted if the amount of the equity they have in their home is in the range of $878,000. However, Medicaid does have the right to collect from a beneficiary’s equity in his home following his death. Thus, many individuals adopt measures to shield their home against Medicaid and estate collection. It is typically essential to get the help of an attorney in order to take the measures. The applicants whose spouse or child under the age of 21 blind, visually impaired, or reside in the same home are not affected by the limit of $878,000.

Holocaust Restitution Payments

Holocaust Restitution funds are exempt from taxation. This means that, even when someone has received payments for a long time and can prove the total amount of money received, he can keep the entire amount and still be eligible for Medicaid.

Spousal Impoverishment Allowance

Spouses of Medicaid beneficiaries who are enrolling within Managed Long-Term Care (MLTC) plans have the right to a resource allowance that is the higher of $74,820 or half of the couple’s total assets of $126,420. It is added to allocation of resources, which is $15.450.

Note: This article is a basic guideline for eligibility and does not cover more complex methods such as the transfer of assets or refusal to marry.

We can assist you in the application process in Medicaid in home health care. If you require assistance for yourself, your loved ones or a customer you can contact us. Call Us Now! 347-891-6577