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Eligibility Requirements for Medicaid/Medical Assistance

Medicaid/Medical Assistance planning can be helpful in obtaining eligibility for these government benefits by Pittsburgh residents, as this blog has discussed previously. There are specific income and resource requirements that a Pennsylvania resident has to meet before he or she can become eligible for Medicaid even he or she is medically needy. This is important to remember because, for many aging Pennsylvania residents, Medicaid may be the only option to help pay for long-term care.

Since Medicaid is administered by the states, even though it is a federal program, eligibility requirements vary from state to state. An adult who happens to need Medicaid to help cover the cost of long term care at home will have to show that his or her monthly income in Pennsylvania does not exceed $2,205 per month. This figures changes annually. For Medicaid nursing home benefits, the individual will have to show that his or her monthly income is less than the average cost of nursing home care, $321.95 per day in 2017, or approximately $9,650 per month.

While most people have income below that figure, what may be more important to aging Pennsylvanians is the program's resource requirements. This is when it can be helpful to do Medicaid/Medicaid Assistance Planning. Generally speaking, a single person can only have limited resources, including a home, household furnishings, one car, a cemetery plot, an irrevocable burial trust or pre-paid funeral, very limited life insurance and usually no more than $2,400 in liquid assets.

For a married couple, the protected assets may be higher since the retirement accounts of the spouse remaining at home are exempt as well as a spousal resource allowance. This spousal resource allowance may range from $24,180 up to $120,900, depending on a couple's assets. However, what does and does not count as an asset can be difficult to decipher given the complexities of the law, which means that the advice of an elder law attorney can be needed.

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