Nebraska Medicaid Long Term Care Eligibility
Nebraska Long Term Care
1. Residency and Citizenship – the applicant must be a Nebraska 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. Persons must need care for thirty (30) consecutive days.
3. Income Limitations – All income, whether earned or unearned, must be considered if received and currently available for the use of the individual (wages, Social Security benefits, pensions, veteran’s benefits, annuities, SSI payments, IRAs, etc.). If a married couple receives income from the same source then the community spouse is allowed to keep up to half of the total until the maximum listed below is reached. Net income for aged or disabled applicants is determined by disregarding the first $60 plus one-half of the remainder. Nebraska uses the Federal Poverty Limit (FPL) as a guideline and offers full coverage to those who receive less than 100% of the FPL (dollar amount changes each year) each month. For those who have income over 100% of the FPL they can designate the excess income for care and receive cash assistance once income falls below the current FPL each month.
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. The state 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. All non-exempt assets of both spouses are available as payment for long-term care expenses.
- Nebraska requires all livestock, poultry and crops (growing and on-hand) to be evaluated. The owner’s estimate of current market price may be used. If the estimate seems inaccurate, other sources such as an auctioneer or a county assessor may be consulted.
- Nebraska also requires applicants to report their value of farm equipment if applicable. Tax assessment records or a farm equipment dealer may be consulted to arrive at a market evaluation. Any loans, liens, etc. must be verified to determine equity.
- Lastly, Nebraska requires applicants to report all business equipment, fixtures, and machinery. The owner’s estimate of current market price may be used. If the estimate seems inaccurate, other sources such as an auctioneer or a county assessor may be consulted.
Exempt Assets for an applicant in Nebraska 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. $6,000 or less in cash/non-exempt assets if married and both spouses require care.
ii. One home is exempt (equity limit $595,000) if planning to return. If a spouse, a child under 21, or a disabled dependent resides in it then there is no value limit.
ii. One car.
iii. Pre-paid funeral plans up to $4,834 for an individual.
vi. Personal effects and household goods.
Amount of assets community spouse may retain: The community spouse can keep non-exempt resources owned by one or both spouses worth a minimum of $25,728 and a maximum of $128,640. 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 $2,113.75 per month. The maximum amount of income a community spouse can keep is $3,216.00.
- There is a personal needs allowance of $60/month for the spouse receiving nursing home care.
Nebraska 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.
Nebraska Department of Health and Human Services extended Medicaid Eligibility: http://www.sos.ne.gov/rules-and-regs/regsearch/Rules/Health_and_Human_Services_System/Title-477/Chapter-20.pdf
Nebraska Department of Health and Human Services Federal Poverty Limits: http://dhhs.ne.gov/Documents/477-000-012.pdf