Medicaid Eligibility for Long Term Nursing Care

Medicaid Eligibility for Long Term Nursing Care

Medicaid is a federally funded health care program for low-income individuals that is administered by the states. While there are many different eligibility groups, this article focuses on elderly Arkansans needing long term nursing facility care. Medicaid pays for the cost of nursing facility care for those who meet certain financial and medical criteria.

The first criterion for nursing facility Medicaid is that the individual must be medically or functionally eligible. This means that the applicant has a condition that warrants full time nursing facility care as prescribed by a physician.

The financial criteria are income and asset based. The current income limit to qualify for Medicaid is $2,313 per month. A spouse’s income is not counted. Applicants frequently fall into what is commonly referred to as the “income gap,” meaning that they earn too much income to qualify for services but not enough income to pay out of pocket the monthly cost of long term care. Applicants who otherwise qualify but for their income may be able to utilize an income-only trust, also called a “Miller Trust.”

An individual’s assets must be below $2,000 to qualify for Medicaid ($3,000 for couples that both require Medicaid). If the individual is married, the assets of both spouses are counted for purposes of determining available resources, even if both spouses do not require nursing facility care. If one spouse requires care and one does not, the spouse not receiving care may keep a portion of the resources up to $123,600 based on a formula. Certain types of assets are not counted when determining available resources.

Contrary to popular belief, the government does not take your property when you go into a nursing facility. However, the government will not pay for your long term care until you have utilized your own resources first. Beware that Arkansas has a five-year look back period so that if an applicant gives away or sells assets for less than fair market value in the five years prior to application, a period of ineligibility will result.

Ashley Naramore is an estate planning attorney with her LLM (Masters of Laws) in Elder Law and Estate Planning. She is one of the best in the state of Arkansas and is available to help you with your estate planning and probate administration needs.

Scroll to top