Ask Thomas Mitchell: How Have Medicaid Qualifications Changed in 2013?



Video Summary


Good afternoon, I'm Tom Mitchell. I'm one of the partners here at Waller & Mitchell.  We're located in downtown New Port Richey, Florida. I'm going to speak to you this afternoon for a few minutes about Medicaid. Medicaid is a joint federal/state program which provides for the medical care for a variety of individuals who are needy. It's a welfare stop program so it does have asset and income qualifications. 


The first group of people that it provides benefits to are families with children, and those benefits are limited to those individuals who make less than 185% of the federal poverty limit. Currently this year, for a family of four, that's about $40,000 so if they're in a family of four, mother and three children, father and mother and two children and make less than $40,000 they would qualify for Medicaid. A family also can be more than just a mother and/or father. It can include people such as grandparents, brothers and sisters, aunts and uncles, cousins, nieces and nephews, so it's a wider-ranging program.


The next group of people who can qualify for Medicaid are the elderly, those over the age 65 – aged, as they're referred to in the federal regulations. So if you're up there and you're 66 and you don't think of yourself as aged, just take my word for it, that's what the federal regulations say. If you're over 65 and you are needy, that is you have income that is less than $710 a month, you can qualify for a program called Supplemental Security Income.  If you receive at least $1 of Supplemental Security Income, you are entitled to Medicaid benefits and you can have your health insurance paid for by the government. 


The other group of people that we frequently encounter that requires Medicaid services are the elderly who are in need of nursing home coverage. This program provides that the state will pay for the nursing home care of an individual who is impoverished. Now this is the federal government and these are the people that pay $2,000 for coffee pots so they have a little bit different idea about what constitutes impoverished. For a single individual it's pretty straightforward. They can't have any more than $2,000 in the bank and can't make any more than $2,135 a month. If they do make more than $2,135 a month, we can prepare a special trust to qualify them in any event, and if you need that, please contact me. I'll be glad to do that for you. 


In the situation with a married couple, the rules are that we don't want the couple to be in poverty. If we know that one of them is going to be in the nursing home, so they're called the nursing home spouse. The other spouse is called the community spouse because they're still living at home in the community, and in that situation, the community spouse is entitled to have $116,550 of assets exclusive of the house and the car. The spouse who's in the nursing home, however, can only have $2,000 and can't have income over the $2,135 that I mentioned a moment ago. 


If you meet those qualifications, the government will pay for the nursing home care of an individual who requires it. There are some ways to plan and to qualify sooner rather than later and this is something that we do do at Waller & Mitchell. If you need this service, please feel free to contact me. Again, my name is Tom Mitchell. I'm one of the partners at Waller & Mitchell. Our telephone number is 727-847-2288. 


Thank you.