Mississippi Medicaid Long Term Care Eligibility
Mississippi Long Term Care
Mississippi is an income cap state, meaning that in order to be eligible for Medicaid long term care benefits there is a hard income limit. Non income cap states allow applicants to spend down money for their care, whereas income cap states require the amount to be no higher than their limit at time of application.
Retroactive benefits: Medicaid applicants may be eligible to receive benefits for up to three months prior to the month of application. To qualify, the person must meet all eligibility requirements during the first three months and have received qualifying medical services in each of the three preceding months.
1. Residency and Citizenship – the applicant must be a Mississippi 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. Persons must apply for, and accept, all benefits for which they may be entitled. For example, VA benefits, retirement or disability benefits, etc. Not accepting entitled benefits may lead to a loss of Medicaid eligibility.
4. 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 $2,205.00 per month. Income in excess of $2,313 can still qualify for Medicaid coverage if excess income is placed into a qualified income or miller trust. There is a deduction for up to one (1) health insurance premium for which the Medicaid recipient has paid. There is a personal needs allowance of $44/month for the spouse receiving nursing home care. Veterans and surviving spouses of veterans who receive a $90 VA pension are able to keep the $90.
5. 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. Mississippi 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. Mississippi 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.
Exempt Assets for an applicant in Mississippi include:
i. $4,000 or less in cash/non-exempt assets if single. If the assets exceed the limit on the first of the month the applicant is ineligible for the entire month.
ii. Personal belongings if the equity value is $4,000 or less.
iii. One home is exempt (equity limit $585,000) if planning to return, 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; or another adult, who lived with the resident and provided care for at least two years thereby delaying institutionalization.
iv. Up to two motor vehicles may be excluded.
v. Burial spaces for family members if under $4,000. Moneys saved for funeral expenses are not counted if $6,000 or less.
vi. Life insurance policies for both spouses if the total face value for each is $10,000 or less. The value of term life insurance is exempt regardless of value.
vii. Personal property may be excluded if the equity value is $5,000 or less.
Amount of assets community spouse may retain: The community spouse can keep non-exempt resources owned by one or both spouses with a maximum of $126,420. 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.
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 $3,160.50 per month. There is also a monthly income allowance for other dependent family members and is based on the dependent’s income.
Manual and procedures: https://www.medicaid.ms.gov/eligibility-policy-and-procedures-manual/#