Do COVID-19 Stimulus Checks Impact Eligibility for Persons on Medicaid? In Nursing Homes? Or Spouses?

Last updated: June 15, 2020

 

Overview

The Coronavirus Aid, Relief, and Economic Security Act, also known as the CARES Act (passed on March 27, 2020) is a $2 trillion economic relief package intended to help offset the huge financial crisis caused by the Coronavirus (COVID-19) pandemic. As part of the CARES Act, the majority of Americans, including those who are elderly and on fixed income, will receive a one-time stimulus check from the Internal Revenue Service (IRS).

Many Medicaid beneficiaries who live at home, assisted living, adult foster care, or nursing homes are concerned the money will put them over the Medicaid income or asset limit, and therefore, disqualify them from Medicaid benefits. In addition, Medicaid applicants express the same concern that the additional money will cause them to have income or assets over Medicaid’s limits, and as a result, prevent them from becoming eligible for Medicaid.

  Stimulus checks will not be counted as income and therefore will not impact Medicaid beneficiaries or applicants. However, should the stimulus money not be spent within 12 months, it will be counted as an asset, and therefore could impact eligibility in the year ahead.

 

Stimulus Check Impact for Medicaid Beneficiaries

Nursing Home Residents

The receipt of a stimulus check by Medicaid beneficiaries who reside in nursing homes will not impact these individuals’ Medicaid benefits. Stated differently, the receipt of the check will not disqualify them from Medicaid nursing home care. This is because Medicaid will not count the money as income, which means it cannot push one over Medicaid’s income limit, and hence, result in the loss of Medicaid benefits.

While Medicaid-funded nursing home residents are required to surrender all of their income except for a personal needs allowance and a monthly maintenance needs allowance for a non-applicant spouse (if applicable) to Medicaid, the money from the stimulus check will not have to be surrendered to Medicaid. This is because, as mentioned above, the stimulus check is not considered as income by Medicaid. Rather, it can be thought of as a tax refund.

Furthermore, the stimulus check will not count as assets, given the money is spent within 12-months of receiving it. So, within this timeframe, a nursing home Medicaid recipient can have possession of the money and it will not impact one’s Medicaid eligibility. However, it is imperative that the money, in its entirety, be spent within one year. If not, the money will count towards Medicaid’s asset limit and can potentially push one over the limit, resulting in Medicaid disqualification.

The money can be spent by nursing home residents in a number of ways. For example, one might buy new clothing, purchase a television for his / her room, stock up on extra snacks, purchase an irrevocable funeral trust, or even give the money to a grandchild. What one does not want to do is to buy assets that are counted towards Medicaid’s asset limit. For instance, collectors coins would most likely be considered an investment and the value of them would be counted towards the asset limit, potentially causing one to be over the limit and lose Medicaid benefits.

The stimulus check will either be direct deposited in the nursing home resident’s bank account or be mailed to the address on one’s 2018 or 2019 tax return. To further clarify, if a refund was issued via direct deposit for one’s tax return, the stimulus check will be directed deposited in the same bank account. If not, the check will go in the mail. Persons who do not have to file tax returns, such as Social Security recipients, will receive stimulus checks in the same manner in which they receive their Social Security benefits. Therefore, if one receives his / her Social Security payment by direct deposit, the stimulus check will automatically be received via direct deposit also.

 Neither Medicaid, nor a nursing home in which a Medicaid beneficiary resides, can take stimulus check money to help cover the cost of their care. To be clear, this money belongs to the stimulus check recipient and Medicaid cannot take it for nursing home care costs. 

 

Spouses of Nursing Home Residents

Spouses of nursing home residents on Medicaid (called Community Spouses), who are not on Medicaid themselves will receive a stimulus check. The receipt of this check will not impact their spouses’ Medicaid eligibility in any manner. First, and foremost, the money from the stimulus check is not considered income by Medicaid, and even if it were, the income of a non-applicant spouse is not considered in the continuing Medicaid eligibility of his / her nursing home spouse.

For Medicaid beneficiaries, the entire check needs to be spent within 12-months of receiving it or the remaining funds will count as assets towards Medicaid’s eligibility. However, the same rule does not hold true for community spouses. To be clear, there is no time limit in which a spouse of a nursing resident must spend his / her stimulus check. Furthermore, non-applicant spouses can spend the stimulus check in any manner they choose, such as paying rent or mortgage, utility bills, food, or even on a splurge, such as a pricey piece of jewelry.

No matter how long it takes for the community spouse to spend the funds, and regardless of how they are spent, it will not impact the institutionalized spouse’s Medicaid eligibility. In other words, a community spouse can be rest assured that it will not cause the nursing home resident to lose his / her nursing home Medicaid benefits. This is because the assets of the non-applicant spouse are not considered for the continuing Medicaid eligibility of his / her Medicaid beneficiary spouse. (The community spouse’s assets are only considered when determining initial eligibility).

The community spouse will receive the stimulus check either via direct deposit or in the mail. Exactly the manner in which it will be received will be based on one’s 2018 or 2019 tax return and how a refund was issued. For instance, if one received a refund via the mail, the address on file will be used and the stimulus check will be mailed to that address. For those who are not required to file tax returns, such as recipients of Social Security, the check will be received in the same way in which their monthly Social Security benefit is received. This means that if it is deposited directly in one’s bank account, the stimulus check will also be direct deposited.

Please note that the institutionalized spouse will also receive a stimulus check. If 2018 or 2019 tax returns were filed jointly, the couple will receive one check (couples who filed joint tax returns are eligible for double the amount of a single filer), while if tax returns were filed separately, each spouse will receive an individual check. Again, for persons on Social Security, there is no need to file tax returns. In this case, checks will automatically be received in the same manner in which Social Security benefits are received.

 

Medicaid Waiver Beneficiaries

Home and Community Based Services (HCBS) Medicaid Waiver recipients will receive a stimulus check and it will not impact their Medicaid eligibility if spent within 12-months of receiving the check. This is because the money from the check will never be considered as income, but it will be counted towards Medicaid’s asset limit if not spent within the specified 12-month period.

Due to the variance of where HCBS Waiver recipients reside, i.e., in one’s home, in adult family care (also referred to as adult foster care), assisted living residences, or in memory care (specialized care, generally in a wing of an assisted living residence or nursing home, for persons with Alzheimer’s disease or a related dementia) the manner in which one might spend the funds varies widely. For instance, a senior or disabled individual living at home might make home modifications for safety and accessibility purposes or purchase a household appliance, while one living outside of his / her personal home might spend the extra money on smaller ticket items, such as special snacks or a really comfortable pillow. The Medicaid beneficiary can even donate the money to a favorite charity if he / she so desires.

A word of caution; HCBS Medicaid Waiver recipients need to exercise caution when choosing how to spend the stimulus check. This is because at redetermination, Medicaid will consider all of a Medicaid recipient’s countable assets, and if the individual has assets over the limit, Medicaid benefits will be terminated. Countable assets are generally considered liquid assets, or assets that can easily be converted to cash. As an example, a Medicaid beneficiary should not purchase U.S. Savings Bonds, as this would be counted towards Medicaid’s asset limit.

The stimulus check will be received by the Waiver beneficiary in either one of two ways; It will automatically be deposited into the individual’s bank account or it will be mailed to the address used for his / her 2018 or 2019 tax return. Exactly how it will be received will be determined by how one received a previous tax refund. For clarification purposes, if last year’s tax return was mailed to one’s home, the stimulus check will also be mailed to his / her home. Social Security recipients do not have to file tax returns, but this is no cause for alarm. Persons who receive Social Security benefits will receive the stimulus check in the same method in which Social Security checks are received. This means that if they are received via direct deposit, the stimulus check will be direct deposited in the same bank account.

 

Aged, Blind and Disabled Beneficiaries

Persons who are on Aged, Blind and Disabled (ABD) Medicaid are no exception from other Medicaid recipients and will be issued a stimulus check. The receipt of this money will in no way impact an ABD beneficiary’s Medicaid benefits, meaning the receipt of this check will not cause one to lose his / her Medicaid benefits.

The money will not be considered as income for Medicaid purposes, nor will it be treated as assets for the first 12-months. However, if the money is not spent in its entirety during that timeframe, any remaining funds will be counted as assets by Medicaid and could possibly cause one to lose his / her Medicaid eligibility. However, as long as the money is spent before the end of the 12-months, there is no need for concern at all.

It is important to mention that, theoretically, the money can be spent however a stimulus check recipient sees fit. That said, when it comes to ABD Medicaid recipients who want to ensure they maintain their Medicaid eligibility, this is not true. If, for instance, a Medicaid beneficiary spends the stimulus check money on assets that Medicaid considers as countable, he / she could potentially be over Medicaid’s asset limit and lose Medicaid eligibility. That said, an ABD recipient would not want to use the money to buy stocks, as that would be considered as a countable asset. Instead, the individual needs to spend the money on non-countable assets, such as an irrevocable funeral trust, rent or mortgage, replacing a water boiler, etc. The stimulus check money could also be gifted to a loved one.

The receipt of the stimulus money will be either through a direct bank deposit or a paper check in the mail. The method will be determined by the manner in which a 2018 or 2019 tax refund was paid. This means that if a tax refund was sent out via mail, the stimulus check will be sent in the mail to the same address. While those who receive Social Security checks do not have to file a tax return, these individuals will still automatically receive a stimulus check. The check will be received in the same manner in which the Social Security checks are received. Stated differently, if one receives his / her Social Security check via direct deposit, the stimulus check will also be received via direct deposit.

 

Stimulus Check Impact for Medicaid Applicants

When it comes to applying for Medicaid, the stimulus check is not considered towards Medicaid’s income or asset limit (if spent within 12 months of receiving it) in any of the 50 states nor Washington DC. This means that the receipt of the cash payment will not cause an applicant to be over the income and / or asset limit, and hence, be denied Medicaid benefits.

This hold true regardless of what Medicaid program (ABD Medicaid, nursing home Medicaid, HCBS Medicaid Waiver) an applicant is applying for and regardless of marital status. For clarification purposes, if one’s non-applicant spouse receives a stimulus check, it will not impact the applicant spouse’s eligibility. The only exceptions are if a year passes prior to the Medicaid application process and the non-applicant spouse has not spent his / her stimulus check in its entirety or has purchased assets that are counted towards Medicaid’s asset limit. (For the initial application process, a couple’s assets are considered jointly owned).

It is important that Medicaid applicants spend all of the stimulus check money within 12 months of receiving it. This is because after this amount of time, it is counted towards Medicaid’s asset limit. Furthermore, if one is planning on applying for Medicaid, he / she should be careful to spend the money only on non-countable assets (assets that are not counted towards Medicaid asset limit). Persons can pay their rent, buy groceries and medications, pay off debt, and upgrade their televisions. They shouldn’t, however, invest the money in stocks or buy a whole life insurance policy. This is because they would be considered countable assets and could cause an applicant to be over the asset limit, resulting in Medicaid denial.

Medicaid has a 60-month look back period (Medi-Cal in California is 30-months) in which Medicaid considers all past asset transfers immediately preceding one’s Medicaid application. During this timeframe, the Medicaid agency scrutinizes all past asset transfers to ensure no assets were given away in order to meet Medicaid’s asset limit. If one violates this rule, he / she could be denied Medicaid benefits. However, it is thought that the stimulus money is exempt from this rule, given the money is gifted within 12-months of receiving it. Therefore, a Medicaid applicant, or someone considering applying for Medicaid, could give away the stimulus check money to family members, educational funds, to charity, etc. during the 12-month period. However, after 12-months, the funds would count as assets for Medicaid eligibility purposes and giving the money away would violate Medicaid’s look back rule.

Medicaid applicants will receive their stimulus checks either automatically through direct deposit or by receipt of a paper check through the mail. The exact method of receipt will be determined by how tax refunds were received from one’s 2018 or 2019 tax return. This means that if one received his / her tax return via mail, the stimulus check will also be received in the mail to the same address. While Social Security recipients do not have to file tax returns, this is no reason to worry about the receipt of the stimulus check. This is because the check will automatically be received in the same manner in which one’s Social Security checks are received. For instance, if one’s Social Security checks are automatically deposited into his / her bank account, the stimulus check will automatically be deposited into the same account.

 

Other Questions about the Stimulus Checks

How Much Will the Stimulus Check Be?
The amount of the stimulus check, also called an economic impact payment or recovery rebate, may be for as much as $1,200 / person.

• Individuals who earn up to $75,000 / year will receive a $1,200 check.
• Married couples, filing jointly who earn up to $150,000 / year, will receive a $2,400 check.
• Individuals who earn up to than $99,000 / year will receive a check, but it will be for less than $1,200.
• Married couples, filing jointly who earn up to $198,000 / year, will receive a check, but it will be for less than $2,400.

Payments will be based on one’s tax returns from 2018 or 2019. Please note that for disabled persons and seniors who receive Social Security payments, it is not necessary for a tax return to be filed. (Persons who receive Social Security benefits generally do not have to file a tax return). Rather, the IRS will automatically send out economic impact payments to these individuals.

Checks will be received either via direct deposit or in the mail.

What is the Check Intended For?
The cash payment is intended to help persons pay for basic necessities and support the economy during the Coronavirus pandemic. While there is no limitation as to how the money can be spent, for many Americans, it will go towards one’s rent or mortgage, utility bills, food, and other essentials.

Determine Your Medicaid Eligibility

Get Help Qualifying for Medicaid