Connecticut Medicaid Long Term Care Eligibility
Connecticut Long Term Care:
In Connecticut, Medicaid is also called HUSKY. To be eligible, an institutionalized individual’s countable assets cannot exceed $1,600.00. If married, the Community Spouse Protected Amount (CSPA) can range from $25,728 to $128,640. The amount is determined by adding together the counted assets of both people from the date the institutionalized individual entered the facility. The state then divides the amount in half to establish a spousal share. The amounts update yearly and are determined by federal law. The CSPA cannot exceed the maximum amount, except by Fair Hearing decision or through a court order. If the community spouse’s assets are below the minimum of $25,728 then he/she may keep assets from the institutionalized spouse until the minimum is met. The state looks back 60 months to make sure income was spent down correctly rather than transferred as a lump sum into the name of someone else.
Community spouse impoverishment protection: The community spouse can keep part of the institutionalized spouse’s income if the community spouse has a monthly income of less than $2,113.75. The maximum amount of income that can be retained is $3,216.00, varying by case and need.
Connecticut Classifications of Income:
- Wages, Social Security benefits, pensions, veteran’s benefits
Connecticut Classifications of Assets:
- Bank Accounts, stocks, bonds, annuities, trusts, property insurance, life insurance, cars (beyond one), homes if no one is living in it, non-home property
Connecticut Excluded Assets:
- Principal residence (less than 858,000 equity), household items, jewelry, burial plots, burial funds and arrangements, one car, life insurance policies such as term insurance policies which provide temporary coverage, but have no cash surrender value, are totally excluded, regardless of their face value.
- Trusts for disabled individuals under 65, which qualify under 42 usc 1396p(d)(4)(A), are exempt.
- Annuities that meet certain criteria are exempt.
- Transfers of assets to disabled children and to “caregiver children” who meet certain criteria, do not create a penalty.
- Must be a U.S. citizen or an eligible non-citizen
- Must be a Connecticut resident
- Must be at least 65 years old or eligibly disabled
- Must meet the income requirements mentioned above
- Must need health care services provided by a nursing home or home care
- Not have transferred assets in the past 60 months in order to qualify for assistance. A gift or transfer within the five year look-back period does not permanently disqualify, but only for a period of time (for every $12,604.00 transferred, there is a loss of eligibility for one month)
- Assign a claim to any source of income or resource
- Also, for individuals 19-64 with income under 138% of MAGI, there is eligibility for Husky D (medicaid expansion) with no asset test and this INCLUDES nursing home care
Connecticut Partnership for Long Term Care:
An individual who has purchased a pre-certified long term care insurance policy and has used the policy to pay for services may protect additional assets under the Connecticut Partnership for Long Term Care. Under this program, the Department will disregard assets in an amount equal to the lesser of the following:
- The amount of payments made by the pre-certified long term care insurance; or
- The real cost of services.
Example: John Doe has a pre-certified long term care insurance policy that has paid out 100,000 for covered services over the past few years. His insurance coverage expires and John Doe applies for Medicaid Long Term Care. He is allowed his $1,600 as mentioned above plus an additional 100,000 in asset since that was the coverage of his policy. If he were married, his spouse would also be allowed to have her CSPA.
If you are on Medicaid, you may need to contribute to the cost of your care. Your contribution begins once you in the nursing for 30 days.
You are allowed to keep some money each month:
- $60 personal needs allowance (this amount changes periodically)
- Support for your spouse or other dependent living at home
- Health costs that Medicaid does not pay for
- $90 each month for a single war veteran or spouse of a deceased war veteran with reduced VA Improved pensions
- Some expenses for your home, if you are expected to return within 6 months
While the application is pending in Connecticut, it is recommended you pay the nursing home.