2) Medicaid Waivers / Home and Community Based Services (HCBS) – with these programs, there are participant caps for enrollment.
So adults age 19-64 with household incomes up to 138% of the poverty level are now eligible for Medicaid in Utah… Medicaid is a state/federal program that pays for medical services for low-income pregnant women, children, individuals who are elderly or have a disability, parents and women with breast or cervical cancer. Medicaid Policy TABLE VII - Income Limits for Medical & Medicare Cost-Sharing Programs … *While there is no income limit for nursing home Medicaid, as indicated in the chart above, a beneficiary must pay nearly all of his or her monthly income to the nursing home. (Please see chart, above.) 2) Medicaid Planning – the majority of persons considering Medicaid are “over-income” or “over-asset” or both, but still cannot afford their cost of care. Based on one’s shelter and utility costs, an applicant spouse may be entitled to an even greater amount, up to $3,216 / month. SSI for Single living alone: $783.00 (No State Supplement) SSI for Single receiving In-Kind Support: These programs have slightly different financial and medical (functional) eligibility requirements, as well as varying benefits. See our Resource Limits – Medicaid page. Jointly funded by the state and federal government, it provides health coverage for various groups of Utah residents, including pregnant women, parents and caretaker relatives, adults with no dependent children, disabled individuals, and seniors. Said another way, the income of the non-applicant spouse does not affect the eligibility of the applicant spouse regardless of how much income the non-applicant spouse receives each month. We know there are many rules regarding income, and it’s hard to remember them all. Copyright © 2020 All rights reserved. The monthly income standard varies between approximately 55% and 133% of the Federal Poverty Level, depending on category.
The table below provides a quick reference to allow seniors to determine if they might be immediately eligible for long term care from an Utah Medicaid program.
Prior to submitting an application for Medicaid benefits in Utah, seniors need be certain that all eligibility requirements (as discussed above) for the program in which they are applying are met. Persons in these situations should seriously consider Medicaid planning. $12,200 Unearned: $1,100 Qualifying Relative Limit: $4,200, Single: $281 Couple: $411.66.
In simple terms, one may still qualify for Medicaid services by “spending down” their income to the Medicaid income limit. The expansion extends Medicaid eligibility to Utah adults whose annual income is up to 138% of the federal poverty level ($17,608 for an individual or $36,156 for a family of four).
As of 2020, for married couples with just one spouse applying for Medicaid nursing home care or a HCBS waiver, the community spouse can retain half of the couples’ joint assets (up to a maximum of $128,640), as shown in the chart above. Basically, if the non-applicant spouse, who is also called a community spouse or well spouse, has income under $2,155 / month, as of 7/1/20 (this figure changes each year in July), he or she is entitled to a portion of the applicant spouse’s income (to bring the non-applicant spouse’s income to $2,155 / month). Make note, the Medically Needy Pathway does not assist one in spending down extra assets for Medicaid qualification. Medicaid is a medical program for people who have low-income and limited resources. Being over the income and / or asset limit(s), or being uncertain if eligibility criteria are met, can result in a denial of benefits. Medicaid-funded nursing home beneficiaries are entitled to only a personal needs allowance of approximately $45 / month, and if applicable, pay a monthly income allowance to a non-applicant spouse. Salt Lake City, UT 84116, Early and Periodic Screening, Diagnostic and Treatment, Living Well with Chronic Conditions Program, Medicaid for Long-Term Care and Waiver Programs, Utah’s Premium Partnership for Health Insurance, UAMRP (Utah Access Monitoring Review Plan). In other words, they are exempt. For married couples, with non-applicant spouses’ of institutional Medicaid applicants or HCBS Medicaid waiver applicants with insufficient income in which to live, there is a Minimum Monthly Maintenance Needs Allowance (MMMNA).
Countable assets include cash, stocks, bonds, investments, promissory notes, credit union, savings, and checking accounts, and real estate in which one does not reside. Medicaid is a wide-ranging health insurance program for low-income individuals of all ages. 288 North 1460 West However, one can “spend down” assets by spending excess assets on non-countable ones. The limit is $10,000 for one person and $15,000 for a couple. This can be done by paying excess income to the state of Utah or paying a provider for medical services / goods. Examples include employment wages, alimony payments, Veteran’s benefits, pension payments, Social Security Disability Income, Social Security Income, Supplemental Security Income, IRA withdrawals, and stock dividends.
To be eligible for Medicaid, you must meet a program type and meet the rules for Utah residency, income, and citizenship. In order to apply for Medicaid in Utah, senior residents can do so online at myCase, download and submit a completed paper application (applications are found half way down the webpage), or apply in person at their local Department of Workforce Services (DWS) office. (To locate your local office, click here). 3) Utah Medicaid New Choices Waiver (NCW) – this Medicaid waiver assists seniors and disabled individuals who currently live in an assisted living facility or nursing home to transition back to living in one’s home or the home of a relative.
Medicaid expansion in Utah: Key takeaways. For Medicaid eligibility purposes, any income that a Medicaid applicant receives is counted.
However, this is not the case when one spouse of a married couple applies for regular Medicaid. More on how Medicaid counts income. Persons might also find their local Area Agency on Aging office helpful. Cannon Health Building However, this page is focused strictly on Medicaid eligibility for Utah elders, aged 65 and over, and specifically for long term care, whether that be at home, in a nursing home… There is also a minimum standard, which is $25,728, and if a couple’s joint assets are equal to or less than this amount, the non-applicant spouse can retain 100% of it.
One’s primary home, given the Medicaid applicant lives in it or has “intent” to return to it, and his or her equity interest in it is not more than $595,000 (in 2020), is exempt. For questions or assistance, seniors can also contact DWS at 866-435-7414.
So just fill out your application the best you can and UPP will contact you if there are any questions. It is vital that one does not give away assets or sell them for less than fair market value in an attempt to meet Medicaid’s asset limit. However, for Medicaid eligibility purposes, there are many assets that are not counted.
To be clear, there is no spousal income allowance for non-applicant spouses of those applying for regular Medicaid. Other benefits include adult day care, homemaker services, meal delivery, home modifications and more.
In Utah, the agency that administers the Medicaid program is the Utah Department of Health.
This is because in Utah, as mentioned previously, Medicaid has a “Look-Back” period of 5 years.
This program also allows for self-direction of care services. There are several different Medicaid long-term care programs for which Utah seniors may be eligible. 1) Utah State Plan Personal Care Services – assistance with daily living activities is provided via the state Medicaid plan (available to anyone who meets the eligibility requirements) to promote independent living and prevent nursing home admissions. Jointly funded by the state and federal government, it provides health coverage for various groups of Utah residents, including pregnant women, parents and caretaker relatives, adults with no dependent children, disabled individuals, and seniors. There is no spousal resource allowance for non-applicant spouses of regular Medicaid applicants. Therefore, wait lists may exist.
Anyone who meets the eligibility requirements will receive assistance.
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