The purpose of the MO HealthNet (Medicaid) program is to provide medical services to individuals who meet specific eligibility requirements. Those requirements have been established by the Family Support Division (FSD). The goals of the MO HealthNet program are “to promote good health, to prevent illness and premature death, to correct or limit disability, to treat illness, and to provide rehabilitation to persons with disabilities.”
What is Medicaid in general?
Medicaid is a medical assistance program providing health care benefits to low-income citizens. 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 many cases, recipients of Medicaid benefits are not required to pay for covered medical expenses, except for possibly a small co-payment. Clients often have questions about Medicaid eligibility requirements in Missouri. Here is what you should know about Medicaid law.
Services covered by the Medicaid program
Although Medicaid pays for different types of medical services, it does not necessarily cover everything. Of the services not covered, there are some limits imposed especially for adults. In order to be qualified for some services, you may need to obtain prior approval or authorization from your primary care physician. Medicaid usually pays for some in-home services, but only when a doctor indicates that the home care services are truly needed for specified medical reasons. The Medicaid law in your state will determine which services are covered.
Determining who is eligible under Missouri Medicaid law
Eligibility requirements for Medicaid are typically different from one state to another. Nonetheless, most states offer coverage for adults with children who live below a certain income level, women who are pregnant, seniors and people with disabilities. In addition to the aged, blind, and disabled, the following groups of Missouri residents are eligible for Medicaid:
- Disabled adults
- Adults who have dependent children are eligible, only if their household income is below 18 percent of the poverty level
- Infants under the age of one year are eligible for Medicaid, if their household income is less than 196 percent of the poverty level
- Children ages 1 – 18 are eligible, if their household income is up to 150 percent of the poverty level
- Children above the Medicaid income thresholds may still be eligible for CHIP if their household income is less than 300 percent of the poverty level
- Women who are pregnant are eligible for Medicaid if their household income does not exceed 196 percent of the poverty level
Non-disabled adults who do not have children are not eligible for Medicaid regardless of their income levels. Parents with dependent children are only eligible if their income level does not exceed 18 percent of the poverty level.
When to consider creating your Medicaid plan
It is not too late to start creating your plan for the potential need for Medicaid benefits. Although, it is always best to start as early as you can and plan ahead in order to ensure that you will qualify for Medicaid, there may still be some options available to you later on. Even if you find yourself in need of Medicaid, it’s not too late to take advantage of the Medicaid law to create your plan.
Why Medicaid planning is essential
If there is any chance that you may need long-term care, you should consider Medicaid planning. As you probably know, Medicaid is a need-based benefits program. In other words, in order to be eligible under Medicaid law, you cannot have financial resources of more than $1,000. Although your homestead is generally not included in determining your resources, it is still possible to exhaust all of your savings before Medicaid will start paying for the cost of long-term care. The purpose of Medicaid planning is to prevent that from occurring.
Giving away your property is not the best option
Far too many people believe that they can simply transfer or give away their property to someone else, before applying for Medicaid benefits. The truth is, if you do that at any time within five years of submitting your Medicaid application, a period of ineligibility will likely be imposed. In other words, you cannot receive any benefits until that period is over. Therefore, the timing of any property transfers is important to your early planning.
How can I protect my assets before being admitted to a nursing home?
Most clients believe there aren’t any steps they can take to protect their assets when they need long-term nursing home care. But, that is not always the case. With proper advance planning, you can retain control of your assets and still qualify under Medicaid law. The earlier you start planning the better off you will be.
Join us for a FREE workshop! 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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