If you are confused about who can qualify for Medicaid, you aren’t alone. While Medicaid provides much-needed assistance for many seniors, figuring out what you can get—and how to get it—can be a challenge. Asking the question, “Do my parents qualify for Medicaid?”, is just the beginning of the process.
“It’s a means-tested entitlement program,” says Anthony Enea, an elder law attorney and managing partner at Enea, Scanlan & Sirignano, LLP in White Plains, NY. The program helps with nursing home costs, as well as financial assistance for those with low incomes.
Under the Affordable Care Act, some states have chosen to expand their Medicaid programs. If your parent is under 65 and resides in a state that has expanded its Medicaid coverage, they may be in luck. States that have expanded Medicaid cover adults who make up to 133% of the national poverty level, regardless of age.
In states that haven’t expanded their Medicaid programs, general qualifications for seniors require a person to be the following:
- At least 65
- A U.S. citizen or legal resident
- A resident of the state where they apply
- Have a permanent disability
If you want to ease the application process, keep financial records. According to Enea, most people run into issues because they don’t keep adequate bank records. Five years’ worth of your income records can come under scrutiny, and certain transfers can affect your eligibility.
For example, if you transferred or gifted someone an asset for less than the fair market value during the past three to five years, this can count against your Medicaid eligibility. Examples of transferred assets include property such as cars and homes.
“If gifts were made in the potential ‘look back’ period, then there’s a potential eligibility problem,” Enea notes.
However, you can transfer your home without penalty in some circumstances. Common exemptions include a home transfer to these individuals:
- A spouse, or another person solely for the spouse’s benefit
- A disabled child
- A child under the age of 21
- A child caretaker who lived in the home for two years before the homeowner entered long term care.
- A sibling who has equity in the home and who lived in the home for at least one year before the loved one entered long-term care
Other transfer exceptions can apply, depending on the recipient. For example, property transfers for a spouse or a disabled child are also exempt.
Know Your income
Since Medicaid is often income-dependent, you will want to know what the government counts as income. Income includes:
- Salaries, wages and pensions
- Social security and disability payments
- Veterans benefits
- Interest from savings accounts and CODs
- Dividends from stocks and bonds
When you start by asking, “Do my parents qualify for Medicaid?”, these answers can help your family get the right information.