Minnesota Medicaid Long Term Care Eligibility

Minnesota Long Term Care

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Before someone can begin to receive long-term care benefits, they must be institutionalized continuously for at least 30 days in a nursing home, ICF/MR, or hospital. The recipient must also be screened by a long-term care consultant with the expectation of receiving an Elderly Waiver or Alternative Care within 60 days of the screening— with services expected to be provided for at least 30 consecutive days. The asset limitations described below are counted starting on the first day of the continuous period of institutionalization, even if the recipient applies for long-term care benefits at a later date.

Eligibility:

1. Residency and Citizenship – the applicant must be a Minnesota 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. The applicant must meet certain medical requirements consistent with the level of care requested.

3. Income Limitations – if single, the applicant’s income (wages, Social Security benefits, pensions, veteran’s benefits, annuities, SSI payments, IRAs, etc.) must be less than $973 per month. Income in excess of $973 can still qualify for Medicaid coverage if excess income is spent down to pay for care. If married, the income limit is $1,311 per month. There is a personal needs allowance of $89/month which is not figured 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. Minnesota 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. Minnesota considers anything owned as an asset, barring exemptions. Financial eligibility is reviewed once a year with no time limit on how long care services can be given.

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Exempt Assets for an applicant in Minnesota include:

i. $3,000 or less in cash/non-exempt assets if single; if married, the asset limit is $6,000. If the assets exceed the limit on the first of the month the applicant is ineligible for the entire month.

ii. Personal effects and household goods.

iii. One home is exempt (equity limit $560,000) if a spouse, a child under 21, or a disabled person resides in it. The house can be transferred with no penalty to the spouse; a natural, adopted, or step child who is under 21, blind or disabled; a sibling who has equity interest in the home and lived with the institutionalized individual one year prior to institutionalization; another adult, who lived with the resident and provided care for at least two years thereby delaying institutionalization.

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. Burial spaces and funds up to $1,500 for each spouse; irrevocable pre-paid burial trusts up to $2,000.

vi. Life insurance policies for both spouses if the total face value for each is $1,500 or less.

vii. Capital and operating assets of a business necessary to earn an income.

Spousal Rules:

Amount of assets a community spouse may retain: The community spouse can keep non-exempt resources owned by one or both spouses with a minimum of $33,851 and a maximum of $120,900. If the community spouse’s assets do not equal the minimum, the long-term care spouse is able to transfer assets until the minimum is reached.

  • If the combined assets of the couple are between $66,557 and $234,496, each spouse is able to keep one half of the total assets. If the combined assets are $234,496 or over, the community spouse keeps up to $119,220 with the institutionalized spouse retaining the amount over $117,248. The institutionalized spouse must contribute all countable assets towards his/her care with an exempted maximum of $3,000.

Community spouse impoverishment protection: The community spouse can keep part of the institutionalized spouse’s income if the community spouse has an income of less than $2,005 per month. If the community spouse can document high shelter expenses (rent, utilities, phone, etc.) then the income limit may be raised to a maximum of $3,022.50. Minnesota is an “income first” state, meaning the state limits the right to petition for an increased community spouse resource amount (CSRA) to couples whose combined income fails to meet the community spouse’s income needs. Basically, this means a community spouse can petition for an increased CSRA where there’s an income gap only after factoring in the nursing home spouse’s income first.

Minnesota 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.

Further Reading:

2014 legislature guide to long term care funding: http://www.house.leg.state.mn.us/hrd/pubs/MAasset.pdf
Application forms for Minnesota: https://mn.gov/dhs/people-we-serve/adults/health-care/health-care-programs/resources/paper-applications.jsp