Do you know someone who has spent time in a nursing home? Have you ever thought it could be you? For married couples where only one spouse applies for a Medicaid nursing home or an HCBS Medicaid waiver, there is a minimum monthly child support assistance (MMMNA). This is the minimum monthly income to which the non-applicant spouse is entitled. As of January 2020, that number is $3,216/month. In principle, if the non-applicant has income below this amount, the applicant spouse may transfer some or, in some cases, all of his or her income to bring the non-applicant`s income to that amount. While some states use both a minimum number and a maximum number, the state of Ohio uses a standard number. This rule on impoverishment of the spouse is intended to ensure that the non-applicant spouse has sufficient means of subsistence. To be clear, this rule does not apply to regular Medicaid. For Medicaid eligibility, any income received by a Medicaid applicant is counted. To clarify, this income can come from any source. Examples include employment wages, alimony, pension payments, Social Security disability income, Social Security income, IRA withdrawals, and stock dividends. However, if only one spouse of a married couple applies for a Medicaid nursing home or a Medicaid exemption, only the applicant`s income will be counted. In other words, the income of the non-applicant spouse is not taken into account.

For married couples where one spouse applies for regular Medicaid, the combined income of the applicant spouse and the non-applicant spouse counts towards the income limit. (Click here to learn more about how Medicaid counts income for entitlement purposes.) All forms of long-term care are expensive. Home care agencies charge between $22 and $30 per hour for personal care assistants. In some cases, people pay more than $200,000 a year for 24-hour home care. Assisted living facilities typically charge $3,000 to $5,000 per month. The cost of a nursing home ranges from $7,000 to over $10,000 per month. A year in a nursing home can easily consume more than $100,000. 2) Assisted Living Exemption – For individuals who would otherwise require care at the nursing home level, the Assisted Living Exemption provides an alternative. To be clear, this program does not cover the cost of accommodation and meals. Rather, it helps cover the cost of care services in assisted living facilities. Registration is limited and not all assisted living facilities in the state accept the waiver. ii.

A house is exempt ($595,000 limit) if a spouse, child under 21 years of age or person with a disability lives in it. Every time an institutionalized person sells a previously vacated apartment, the money from the sale becomes a countable asset. The beneficiary can then lose his/her Medicaid eligibility until he/she has spent the money and his/her countable resources are again below the maximum. The apartment can also be transferred to a brother or sister who has lived in the apartment in the previous year or holds a stake in the apartment; or a child who has provided care and lived in the home for at least two years, preventing the applicant from entering a nursing home. Ohio Department of Aging, Long Term Care: aging.ohio.gov/services/ombudsman/ Ohio Guide to Long-Term Care Services: dsas.cuyahogacounty.us/pdf_dsas/en-US/MedicaidBenefitsBookle.pdf Medicaid Fact Sheet for the Elderly and People with Disabilities (2010): www.co.lucas.oh.us/DocumentCenter/View/44484 Ohio Waivers Service Comparison: medicaid.ohio.gov/Portals/0/For%20Ohioans/Programs/Waivers/crosswalk-final-2015-01.pdf Ohio Long-Term Care Insurance Guide: www.insurance.ohio.gov/Consumer/OCS/CompleteGuides/Complete_Guide_LTCare.pdf 4. Asset restrictions (exempt or available) – Medicaid divides assets into two categories: exempt and available. Exempt property is explicitly identified in the regulations, and ownership of an exempt asset by the applicant does not result in a denial of benefits. If an asset is not listed as exempt, it must be liquidated and applied to the cost of nursing home care before the applicant can receive Medicaid benefits. The state has a retroactive period of 5 years with a penalty for people who sell assets below the fair market price, transfer assets to others, or give money and property. While a person who believes they will not need long-term care in the next five years may try to protect their wealth simply by giving it to their children, such an approach carries risks. We need to realize that no matter how healthy we may look today, there is no guarantee that we will stay healthy for the next five years. A car accident, sudden stroke or fall down the stairs can cause chronic illnesses that require long-term care.

As a result, all assets transferred for Medicaid planning purposes should be preserved so that they are available in case long-term care becomes necessary before the five-year review is completed. Property given to children is often at risk of being lost. If a child divorces, the spouse may acquire a significant portion of the property transferred in divorce proceedings. A child can become a defendant in a dispute and the transferred assets can be used to comply with a court order. In addition, a child may have poor financial management skills and spend transferred assets inappropriately. For these reasons, assets should never be transferred directly to children when they engage in Medicaid planning. Nursing home care is a law program in Ohio, but the state`s Medicaid program also offers several programs that help seniors live outside of nursing homes. William`s sentence is 10 months. William is responsible for paying the full cost of the nursing home during these 10 months. In the 11th month after his application is approved, he is eligible for Medicaid long-term care benefits, but must pay the nursing home an additional amount that month to cover a fraction of the penalty period. Medicaid is a large-scale, jointly funded state and federal health program for low-income people of all ages.

However, this page focuses solely on Medicaid eligibility for Ohio residents 65 and older, and especially for long-term care, whether at home, in a nursing home, or in an assisted living facility. Note that Medicaid is called Medical Assistance (MA) in Ohio. 1) Institutional/Medicaid Nursing Home – is a claim (anyone eligible receives support) and is provided only in nursing homes. 2) Medicaid/Home and Community Services (HCBS) waivers – Limited number of participants. At home, in adult daycare or assisted living. 3) Regular Medicaid/Aged Blind and Disabled – is a claim (meeting eligibility criteria ensures support is provided) and is available at home or in adult daycares.