Medicaid distinguishes between two types of service levels, Community Care and Institutional Care. Depending on the level of care you need, the eligibility requirements differ. Before delving into those requirements, let me restate the difference and first clarify the types of care.
COMMUNITY CARE (aka “Home Care”): Community Care refers to staying in the home and receiving in home health aids or skilled care in your home.
INSTITUTIONAL CARE (aka “Nursing Home”): Institutional Care is Medicaid’s term for a nursing home, whether it’s a short or long term stay.
Regardless of which Medicaid service you are applying for, the eligibility criteria are determined by both income and resources.
To qualify for Community Care, the income for a one person household is $767 and a two person household is $1,137. The resources of a one person household is $13,800 and for a two-person household is $20,100 plus exempt assets. (Please see our related post on Exempt Assets.)
For those applicants needing Institutional Care, the applicant’s income cannot exceed $50 while the spouse remaining in the home (aka “Community Spouse”) is $2,739. The Community Spouse’s resource allowance ranges from $74,820 up to $109,560. This allowance can be increased if a hearing is requested and judicial approval is received, and is only granted in “exceptional circumstances.” See also our related post on Spousal Refusal.
For help in determining whether you or a loved one meets the current income and asset eligibility requirements for Medicaid, contact attorney Moira Laidlaw at (914) 767-0646 or email Moira at mlaidlaw@laidlawfirm.com.
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