New Hampshire Medicaid Long Term Care Eligibility
New Hampshire Long Term Care
1. Residency and Citizenship – the applicant must be a New Hampshire resident and 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 – if single, the applicant’s income (wages, Social Security benefits, pensions, veteran’s benefits, annuities, SSI payments, IRAs, etc.) must be less than the Medicaid reimbursement rate for cost of care. Because the Medicaid reimbursement rate generally exceeds $4,000, only persons with very high monthly income will be disqualified. Beyond the personal needs allowance of $70, the institutionalized person must use all of his income to pay for care.
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.
- There is no disqualification period for transfers made to a spouse or a permanently and totally disabled child.
- New Hampshire looks at transfers of property into trusts for at least 60 months back.
Exempt Assets for an applicant in New Hampshire include:
i. $2,500 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. One home is exempt (equity limit $595,000) if planning to return, a spouse, a child under 21, or a disabled person resides in it. New Hampshire allows a Medicaid recipient to use some income to maintain their residence if a doctor believes he/she is likely to return home within three months. If the home is rented or otherwise income producing the state does not require a sale of the home. If the home is owned jointly with another person who refuses to sell the home then the home will not become a disqualifying asset. Whenever an institutionalized person sells a previously exempted residence, the money from the sale becomes a countable asset. The recipient may then lose eligibility for Medicaid until he/she has spent down the money and their countable resources are once again $2,500 or less.
- If the Medicaid recipient is the sole owner of the home with no spouse or child residing in it, and has no expectation of return, then the house must be sold within six months. The six month period can be extended if there is viable evidence the homeowner has been trying to sell the house at fair market value.
iii. One car.
iv. Pre-paid funeral plans, no amount specified.
v. Life insurance policy if the face value of said policy is $1,500 or less. There is no limit on a life insurance policy where the state is the named beneficiary. A person can still qualify for up to three months even if the life insurance policy exceeds the asset limit as long as the medical or nursing home bills offset the excess countable assets.
vi. Assets placed in a joint account made on or after November 1, 1995 are considered entirely available unless it can be proven that the other owners of the account contributed towards the total value.
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 $128,640. If the community spouse’s assets do not equal the minimum of $25,728, the community spouse is able to retain assets from the institutionalized spouse 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. Depending upon living expenses, a community spouse may keep up to a maximum of $3,216.00 per month. New Hampshire is an “income first” state. This means 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.
New Hampshire 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.
New Hampshire Department of Health and Human Services Nursing Home Care page: http://www.dhhs.nh.gov/dcbcs/beas/nursinghome.htm
How to apply for long term care: http://www.dhhs.nh.gov/dcbcs/beas/eligibility.htm