Medicaid is an assistance program that provides healthcare benefits to individuals with limited assets. Federal, state and local taxes are used to fund this program and those funds are used to help eligible individuals pay their medical expenses. In most cases, Medicaid recipients are not required to pay anything for covered medical expenses, with the exception of a small co-payment. Many clients have questions about Missouri Medicaid eligibility. Here is what you need to know.
Other services covered by Medicaid
Although Medicaid pays for a variety of medical services, it does not cover everything. Of those services it does cover, there may also be limits, especially for adults. In order to qualify for certain services, you may need prior approval or authorization from your primary care physician. Medicaid will typically pay for some in-home services, but only if a doctor says the home care services are actually needed for specific medical reasons.
Who is eligible for Missouri Medicaid?
Eligibility requirements for Medicaid may also differ from one state to another. However, most states offer coverage for adults with children living below a certain income level, pregnant women, seniors and individuals with disabilities. In addition to the aged, blind, and disabled, the following categories of Missouri residents are eligible for MO HealthNet Medicaid in Missouri:
- Adults without dependent children are not eligible at all (this is generally the case in states that have not expanded Medicaid) unless they’re disabled.
- Adults with dependent children are only eligible if their household income doesn’t exceed 18 percent of poverty level. This is about $3,562 a year for a family of three; only Texas has a more stringent guideline, at 15 percent.
- Infants under one are eligible for Medicaid if their household income is up to 196 percent of poverty.
- Children 1 – 18 are eligible if their household income is up to 150 percent of poverty.
- Children above the Medicaid income thresholds are eligible for CHIP if their household incomes are up to 300 percent of poverty. This is among the more generous limits in the country.
- Pregnant women are eligible for Medicaid if their household income does not exceed 196 percent of poverty.
Missouri has not chosen to expand Medicaid. Non-disabled adults without children are not eligible for Medicaid regardless of how low their income is, and parents with dependent children are only eligible with incomes that don’t exceed 18 percent of the poverty level.
When should I consider Medicaid planning?
Despite what you might think, it is never too late to plan for Medicaid. While, it is better to start early and plan ahead in order to ensure that you will qualify for Medicaid should the need arise, there may still be options later on. Even if you unexpectedly find yourself in need of Medicaid, or a loved one does, it’s not too late to talk to your Missouri Medicaid attorney to discuss options.
Why Medicaid planning is important
If there is any possibility that you will need long-term care, you need to consider Medicaid planning. First, of all, Medicaid is a need-based benefits program. That means, in order to be eligible for Medicaid, you cannot have financial resources totaling more than $1,000. Although your residence or homestead is not included in that calculation, it is still pretty easy to spend all of your savings before Medicaid will start paying for the cost of long-term care. The purpose of Medicaid planning is to keep that from happening.
Giving away your property is not the answer
Many people have the mistaken belief that they can simply transfer their assets to someone else, in preparation for applying for Medicaid benefits. However, if you do that at any point within five years of applying for Medicaid, a period of ineligibility will be imposed. That means, you won’t receive any benefits until that period has ended. For that reason, the timing of your transfers is important and early planning is critical.
How can I protect my assets before going into a nursing home?
Many clients believe there is nothing that can be done to protect their assets from Medicaid when they need long-term nursing home care. That is not the case. With properly advance planning it is possible to preserve some or all of your assets while still qualifying for Medicaid. The earlier you start planning the better off you will be. Whether you are facing long-term care issues yourself or you have a family member who is, call us with your questions.
If you have questions regarding Medicaid, or any other elder law matters, contact the experienced elder law attorneys at Gaughan & Connealy for a consultation either online or by calling us at (816) 974-3030.
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