How does one determine Medicaid eligibility for long-term care in Ohio? First, we should differentiate Medicaid from Medicare. Medicare is insurance. Medicaid is a need-based program. Need-based programs are aimed at individuals who cannot afford to pay for the services themselves.
In order to qualify for Medicaid, an individual must qualify for all three of the following:
- Categorical eligibility;
- Countable income must be at or below a certain level; and
- Countable, available resources must be at or below $1,500.
Categorical eligibility. An individual can be eligible for Medicaid to pay for nursing home care only if he or she is 65 or older, blind, or disabled. If the person meets the nursing facility level of care, that person is presumed to be disabled. The nursing facility level of care depends on the individual requiring: hand-on assistance with two activities of daily living; hands-on assistance with one activity of daily living and assistance with medications, supervision 24 hours per day to prevent harm, skilled care at less than skilled level, and skilled care at skilled level.
Income eligibility. The individual’s income must be equal to or less than the monthly Medicaid reimbursement rate for the facility, or equal to or less than the income cap for waiver services. Income includes earned or unearned income, including, but not limited to Social Security, pension, IRA distributions, and trust distributions. However, Supplemental Security Income (SSI), VA benefits based on need, grants, scholarships, and certain other exempt income are not counted as income for Medicaid eligibility.
Resources must be at or below $1,500. However, Medicaid excludes the value of:
- The home and the land associated with it, occupied by the individual, the individual’s spouse, a dependent (under 21), blind or disabled child, a child 65 or over who is dependent on the applicant for housing and whose income does not exceed the income standard, or a sibling with a verified equity interest in the home who has lived in the home for the past year.
- Life insurance with a face value equal to or less than $1,500.
- Irrevocable burial contracts for the individual or spouse, and burial space for individual, spouse, and family members.
- One motor vehicle, if used for medical transportation, or employment, if handicapped equipped, or if there is a community spouse; otherwise, one motor vehicle up to $4,500 in value.
- Income producing property used to meet basic living needs. Equity is excluded up to $6,000 only if income produced exceeds 6 percent of equity.
- Property that produces goods or services to provide for basic living needs, up to a maximum of $6000 in equity.
- Real or personal property essential to the means of self-support.
- Receipt of certain lump sums, such as retroactive benefits, Social Security/SSI, for the first 6 months after receipt.
- Any resource that is not otherwise available for use by the individual. This includes property with a co-owner that refuses to sell the property.
To read more, take a look at my other articles on estate planning and probate: Ohio Medicaid planning with long term care insurance, Ohio Medicaid guidelines, Ohio will requirements, death taxes, and you can’t fix a bad will after you are gone. My hard work has yielded successful results for my clients, as indicated by the following comments: Daniel Gigiano reviews; Daniel Gigiano ratings; Daniel Gigiano work.
Attorney Gigiano is a Wadsworth estate planning attorney in Medina County, with his office located at 102 Main St., Ste. 200, Wadsworth, Medina County, Ohio. His dedication to his client’s interests has earned positive reviews for Daniel Gigiano in numerous websites. Some of the work Attorney Gigiano has done throughout his career can be viewed in various articles and links. If you have questions about this or other questions you need answered by a Wadsworth Medicaid Planning Attorney in Medina County, please call Attorney Daniel F. Gigiano at 330-336-3330.