Qualifying for Homecare Medicaid

Q: How can I qualify for Home-Care Medicaid?

A: Community Medicaid, commonly referred to as Home-Care Medicaid, pays for a variety of medical services that can enable individuals who require assistance with activities of daily living (e.g. dressing, bathing, toileting, and feeding) to continue to live in their homes. Importantly, Community Medicaid will pay for personal home-care aids, up to a determined number of hours per week, who can assist with these activities of daily living.

To be eligible for Community Medicaid, one must meet the applicable income and asset limits. In 2023 the asset allowance for an individual applicant is $30,182 and the monthly income allowance is $1,677/month. As to the non-applicant spouse, the Community Spouse Resource Allowance (CSRA) is $148,620 and their income allowance is $3,715 per month (and a portion of the applicant’s income may be used to help reach this limit).

Any income in excess of the monthly limit will have to be paid to the Department of Social Services each month as a contribution toward any care received. To avoid this, an elder law attorney can create a Pooled Income Trust. Pooled Income Trusts are trusts that are established and managed by non-profit organizations for the benefit of people with disabilities. Medicaid applicants can deposit any excess income into a Pooled Income Trust each month so as to stay under the monthly income limit. Then, the Medicaid recipient can submit bills for household expenses to the Pooled Income Trust which will draw from the excess income that has been deposited. It is important to use the monies in the Pooled Income Trust because when the applicant passes away, the balance goes to the charity.

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It is worthing noting that certain assets are exempt for purposes of determining eligibility i.e. the asset won’t count toward the $30,182 asset allowance. Specifically, the primary residence of the applicant is exempt up to a maximum value of $1,033,000. However, while the primary residence is exempt for purposes of determining eligibility, Medicaid has the right to place a lien on the property to recover the value of services provided if the applicant is not survived by a spouse and the property is part of the applicant’s probate estate (meaning the property passes through the applicant’s Will or by intestacy if there is no Will).

An experienced elder law attorney can help protect the home from this estate recovery by creating a trust for the property in addition to creating a Pooled Income Trust to preserve excess income, as well as prepare the necessary paperwork for the Community Medicaid application.

Nancy Burner, Esq. and Britt Burner, Esq. attorneys at Burner Prudenti Law, P.C. focusing their practice areas on Estate Planning, Elder Law and Trusts and Estates. Burner Prudenti Law, P.C. serves clients from New York City to the east end of Long Island with offices located in East Setauket, Westhampton Beach, Manhattan and East Hampton.