Kansas Medicaid Long Term Care Eligibility
Kansas Long Term Care
In Kansas, Medicaid covers nearly 65% of all nursing home residents. However, Medicaid does not cover assisted living or continuing care retirement communities (with the exception of skilled nursing units). Medicaid in Kansas only pays for care at nursing homes or Intermediate Care Facilities for the Mentally Retarded.
For community and home based services, Kansas has waivers or a program called the Senior Care Act (SCA), which is for Kansans 60 or older who are able to remain at home, but need assistance with some activities. Care options vary by county, with admittance to the program determined by a functional assessment with income guidelines adjusted each July. Patients pay either a donation or 100% cost with a sliding fee scale based on income and assets.
Community and home based waivers: Autism; Frail Elderly; Intellectually/Developmentally Disabled; Physically Disabled; Traumatic Brain Injury; Money Follows the Person; Technology Assisted.
- Applicants must be eligible for Medicaid Long Term Care in addition to individual program requirements before they will be granted community and home based waivers.
1. Residency and Citizenship – the applicant must be a Kansas resident and be a U.S. citizen or have proper immigration status.
2. Age/Disability – the applicant must be age 65 or older, or blind, or disabled and can receive care in home or at a facility. The applicant must meet certain medical requirements consistent with the level of care requested.
3. Income Limitations – the applicant’s monthly income (wages, Social Security benefits, pensions, veteran’s benefits, annuities, SSI payments, IRAs, etc.) must be less than 244% of the Federal Poverty Level. However, all income above $62.00 per month must be used to help pay for care. The personal needs allowance of $62/month is not factored into the total countable income.
4. Asset Limitations (Exempt vs. Available) – Medicaid divides assets into two categories: Exempt and Available. Exempt assets are specifically designated under the rules, and ownership of an exempt asset by the applicant will not result in a denial of benefits. If an asset is not listed as exempt then it needs to be liquidated and applied toward the costs of nursing home care before the applicant can receive Medicaid benefits. Kansas has a look back period of 5 years with a penalty for people who sell assets below fair market price, transfer assets to others, or give money and property away.
Exempt Assets for an applicant in Kansas include:
i. $2,000 or less in cash/non-exempt assets if single.
ii. Personal effects and household goods
iii. One home (equity value limited to $595,000) if intending to return, under the name of a spouse, or a child under 21, or a disabled person resides in it.
iv. One motor vehicle if the vehicle is used for the long term care recipient’s medical treatment, employment, modified to accommodate a disability, or the primary vehicle of the community spouse—no matter the value.
v. Enough money to pay for private health insurance.
vi. Burial spaces and irrevocable pre-paid burial trusts if tied to specific funeral or burial services.
Amount of assets community spouse may retain: The community spouse can keep one-half of all non-exempt resources owned by one or both spouses with a minimum of $25,728 and a maximum of $128,640. All non-exempt resources of both spouses are available to pay for the costs associated with long term care.
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 per month. Depending on living expenses, the maximum amount of income a community spouse can keep each month is $3,216.00.
- Again, the person in the nursing home must contribute all income except $62 per month towards their long term care costs.
Kansas long term care insurance partnership:
This is a program between the state and private insurance companies. Partnership policies protect assets by matching dollar for dollar what policy holders pay into their policies. For example, if you bought a Partnership Policy with a maximum benefit payout of $155,000 then you are able to protect $155,000 of your assets. For married couples each spouse needs to purchase their own policy. Once the $155,000 worth of long term care coverage is used, you may apply for Medicaid with $155,000 worth of assets exempted.
Kansas Client assessment, referral and evaluation: http://www.kdads.ks.gov/commissions/commission-on-aging/client-assessment-referral-and-evaluation-(care)
Kansas Department of Aging: http://www.kdads.ks.gov/