Connecticut Medicaid (HUSKY Health) Eligibility for Long Term Care: Income & Asset Limits

Last updated: November 22, 2023

 

Connecticut Medicaid Long-Term Care Definition

Medicaid is a health insurance program for low-income individuals of all ages. While coverage is provided for differing groups of Connecticut residents, this page is focused on long-term care Medicaid eligibility for CT elders, aged 65 and over. In addition to care services in nursing homes, adult foster care homes, and assisted living residences, Connecticut Medicaid pays for non-medical services and supports to help frail seniors remain living at home. There are three categories of Medicaid long-term care programs for which CT seniors may be eligible.

1) Institutional / Nursing Home Medicaid – An entitlement; anyone who meets the requirements will receive assistance. Benefits are provided only in nursing home facilities.

2) Medicaid Waivers / Home and Community Based Services (HCBS) – Not an entitlement; there are a limited number of participant enrollment slots and waiting lists may exist. Intended to delay the need for nursing home care, benefits are provided at home, adult day care, adult foster care homes, or assisted living residences. More on Waivers.

3) Regular Medicaid / Aged Blind and Disabled – An entitlement; anyone who meets the eligibility requirements are able to receive services. Limited long-term care services, such as personal care assistance or adult day care, may be available.

Medicaid in Connecticut is also called HUSKY Health. Medicaid for state residents who are aged, blind & disabled is called HUSKY C. While Medicaid is jointly funded by the state and federal government, it is administered by the state. The Connecticut Department of Social Services (DSS) is the administering agency.

  The American Council on Aging now offers a free, quick and easy Medicaid Eligibility Test for seniors.

 

Income & Asset Limits for Eligibility

The three categories of Medicaid long-term care programs have varying financial and medical eligibility criteria. Further complicating eligibility is that the financial requirements change annually, vary with marital status, and that Connecticut offers multiple pathways towards Medicaid eligibility.

 Simplified Eligibility Criteria: Single Nursing Home Applicant
Connecticut seniors must have limited income and assets, and a medical need to qualify for Medicaid long-term care. In 2024, a single Nursing Home Medicaid applicant must meet the following criteria: 1) Income under the cost of nursing home care 2) Assets under $1,600 3) Require a Nursing Home Level of Care.

The table below provides a quick reference to allow Connecticut seniors to determine if they might be immediately eligible for long-term care from a CT Medicaid program. Alternatively, one can take the Medicaid Eligibility Test. IMPORTANT: Not meeting all of the criteria does not mean one is ineligible or cannot become eligible for Medicaid in Connecticut. More.

2024 Connecticut Medicaid Long-Term Care Eligibility for Seniors
Type of Medicaid Single Married (both spouses applying) Married (one spouse applying)
Income Limit Asset Limit Level of Care Required Income Limit Asset Limit Level of Care Required Income Limit Asset Limit Level of Care Required
Institutional / Nursing Home Medicaid Income must be less than the cost of nursing home* $1,600 Nursing Home Income must be less than the cost of nursing home* $3,200 ($1,600 per spouse) Nursing Home Income must be less than the cost of nursing home* $1,600 for applicant & $154,140 for non-applicant Nursing Home
Medicaid Waivers / Home and Community Based Services $2,829 / month† $1,600 Nursing Home $5,658 / month ($2,829 / month per spouse)† $3,200 ($1,600 per spouse) Nursing Home $2,829 / month for applicant† $1,600 for applicant & $154,140 for non-applicant Nursing Home
Regular Medicaid / Aged Blind and Disabled $1,182 / month (eff. 7/1/23)‡ $1,600 Help with ADLs $1,910 / month (eff. 7/1/23)‡ $2,400 Help with ADLs $1,428 / month (eff. 7/1/23)‡ $2,400 Help with ADLs
*All of a beneficiary’s monthly income, with the exception of a Personal Needs Allowance of $75 / month, Medicare premiums, and possibly a Needs Allowance for a non-applicant spouse, must be paid towards care costs. This is called a Patient Liability.

†Based on one’s living setting, a program beneficiary may not be able to keep monthly income up to this level.

‡An unearned income disregard of $482 is included in the income limits for a single applicant and a married couple with only one applicant. An unearned income disregard of $964 ($482 / spouse) is included in the income limit for a married couple with both spouses as applicants. Without the unearned income disregard, the monthly income limit for a single applicant is $700, and for married applicants, it is $946.

 

Income Definition & Exceptions

Countable vs. Non-Countable Income
Nearly any income from any source that a Medicaid applicant receives is counted towards the income limit. Examples include employment wages, alimony payments, pension payments, Social Security Disability Income, Social Security Income, Supplemental Security Income, IRA withdrawals, and stock dividends. Nationally, Holocaust restitution payments are not counted as income. Furthermore, in CT, the VA Aid & Attendance pension, which is above and beyond the Basic VA Pension, does not count as income.

Treatment of Income for a Couple
When only one spouse of a married couple applies for Nursing Home Medicaid or a Medicaid Waiver, only the income of the applicant is counted. This means the income of the non-applicant spouse is disregarded and does not impact the income eligibility of their spouse. The non-applicant spouse, however, may be entitled to a Minimum Monthly Maintenance Needs Allowance (MMMNA) from their spouse. The MMMNA is the minimum amount of income a non-applicant spouse is said to require to avoid spousal impoverishment. In CT, the MMMNA is $2,465 (eff. 7/1/23 – 6/30/24).

If a non-applicant’s monthly income falls under $2,465, income can be transferred to them from their applicant spouse, bringing their income up to this level.

In Connecticut, a non-applicant spouse can further increase their Spousal Income Allowance if their housing and utility costs exceed a “shelter standard” of $739.50 / month (eff. 7/1/23 – 6/30/24). However, in 2024, a Spousal Income Allowance cannot push a non-applicant’s total income over $3,853.50 / month. This is the Maximum Monthly Maintenance Needs Allowance. More on how this allowance is calculated.

Income is counted differently when only one spouse applies for Regular Medicaid / Aged Blind and Disabled; the income of both the applicant spouse and non-applicant spouse is calculated towards the income eligibility of the applicant spouse. Furthermore, there is no Monthly Maintenance Needs Allowance for a non-applicant spouse. More on how Medicaid counts income.

 

Asset Definition & Exceptions

Countable vs. Non-Countable Assets
Countable assets are calculated towards Medicaid’s asset limit. This includes cash, stocks, bonds, investments, promissory notes, bank accounts (credit union, savings, and checking), and real estate in which one does not reside. In Connecticut, IRAs are counted. There are also many assets that are not counted; they are exempt. Exemptions include personal belongings, such as clothing, household furnishings, an automobile, a burial plot, an irrevocable prepaid funeral contract (limited to $10,000 in 2024), term life insurance with no cash surrender value, and generally one’s primary home.

Treatment of Assets for a Couple
All assets of a married couple are considered jointly owned. This is true regardless of the long-term care Medicaid program for which one is applying and regardless of if one or both spouses are applicants. However, Spousal Impoverishment Rules permit the non-applicant spouse of a Medicaid nursing home or Waiver applicant a Community Spouse Resource Allowance (CSRA). In CT, this is called a Community Spousal Protected Amount (CSPA). In 2024, the community spouse (the non-applicant spouse) can retain 50% of the couples’ assets, up to a maximum of $154,140. If the non-applicant’s half of the assets is under $50,000, 100% of the assets, up to $50,000 can be retained by the non-applicant. There is no CSRA for a non-applicant spouse of a Regular Medicaid applicant.

Medicaid’s Look-Back Rule
It is vital that one does not give away assets or sell them for less than fair market value within 60-months (5 years) of applying for Nursing Home Medicaid or a Medicaid Waiver. This is because Connecticut has a Medicaid Look-Back Period, which immediately precedes one’s Medicaid application date. During the “look back”, Medicaid checks all past transfers and if assets have been gifted or sold under fair market value, CT’s Medicaid agency assumes it was done to meet Medicaid’s asset limit. A Penalty Period of Medicaid ineligibility is calculated for persons who violate the Look-Back Rule. There is no Look-Back Period for Regular Medicaid.

The U.S. Federal Gift Tax Rule does not extend to Medicaid eligibility. In 2024, this rule allows individuals to gift up to $18,000 per recipient without filing a Gift Tax Return. Gifting under this rule violates Medicaid’s Look-Back Period.

 

Connecticut Medicaid Home Exemption Rules

For home exemption, the Medicaid applicant or their spouse must live in it. If there is no spouse living in the home, there is a home equity interest limit of $1,071,000 (in 2024). Home equity is the value of the home, minus any outstanding debt against it. Equity interest is the amount of the home’s equity that is owned by the applicant. Furthermore, if there is not a spouse in the home, and the Medicaid applicant does not live there, the applicant must have Intent to Return. There is no home equity interest limit for Regular Medicaid. Other exemptions exist.

While one’s home is generally exempt from Medicaid’s asset limit, it is not exempt from Medicaid’s Estate Recovery Program. Following a long-term care Medicaid beneficiary’s death, Connecticut’s Medicaid agency attempts reimbursement of care costs through whatever estate of the deceased still remains. This is often the home. Without proper planning strategies in place, the home will be used to reimburse Medicaid for providing care rather than going to family as inheritance.

 

Medical / Functional Need Requirements

An applicant must have a medical need for long-term care Medicaid. For Nursing Home Medicaid and Medicaid Waivers, a Nursing Home Level of Care (NHLOC) is required. Furthermore, additional criteria may need to be met for specific program benefits. As an example, for a Medicaid Waiver to cover the cost of home modifications, an inability to safely and independently live at home without modifications may be required. For long-term care services via the Regular Medicaid program, a functional need with the Activities of Daily Living (ADLs) is required, but a NHLOC is not necessarily required.

 

Qualifying When Over the Limits

For Connecticut elderly residents, aged 65 and over, who do not meet the eligibility requirements in the table above, there are other ways to qualify for Medicaid.

1) Medically Needy Pathway – Connecticut has a Medical Spend-Down Program for seniors who have income over Medicaid’s income limit. This program allows them to become income-eligible by spending the majority of their income on medical bills, such as private health insurance, unpaid medical bills, and medical expenses that Medicaid does not cover. Effective 7/1/23, the Medically Needy Income Limit (MNIL) for a single applicant is $700 / month, and for married couples, it is $946 / month. The “spend down” amount is the difference between one’s monthly income and the MNIL. In CT, the spend down amount is calculated for a 6 month period. Once the “spend down” is met, one will be income-eligible for the remainder of the period. The Medically Needy Asset Limit is $1,600 for an individual and $2,400 for a couple.

2) Pooled Income Trusts – Disabled seniors in CT applying for a Medicaid Waiver who have income over the limit can become income-eligible by depositing their “excess” income into a Pooled Income Trust. A type of “Special Needs Trust”, this option can eliminate one’s need to “spend down” income, as discussed above. While income deposited into Pooled Income Trusts does not count towards Medicaid’s income limit, trust funds can only be used for limited purposes, such as paying the Medicaid recipient’s bills. Furthermore, upon the death of the Medicaid beneficiary, any remaining funds must be paid to CT’s Medicaid agency.

3) Asset Spend Down – Persons who have assets over Medicaid’s limit can still qualify for Medicaid by “spending down” extra assets. This is done by spending countable assets on non-countable ones. Examples include making home modifications (i.e. the addition of wheelchair ramps or stair lifts), prepaying funeral and burial expenses, and paying off debt. Remember, assets cannot be gifted or sold under fair market value, as doing so violates Medicaid’s Look Back Rule. It is recommended one keep documentation of how assets were spent as proof this rule was not violated.

 Our Spend Down Calculator can assist persons in determining if they might have a Spend Down, and if so, provide an estimate of the amount.

4) Medicaid Planning – The majority of persons considering Medicaid are over the income limit, the asset limit, or both limits, yet they still cannot afford their cost of care. For these persons, Medicaid Planning exists. By working with a Medicaid Planning Professional, families can employ a variety of strategies to not only help them become Medicaid eligible, but also to protect their home from Medicaid’s Estate Recovery program.  Connect with a Medicaid Planner.

 

Specific Connecticut Medicaid Programs

In addition to nursing home care, HUSKY Health (Connecticut Medicaid) provides home and community based programs to help qualified persons live outside of nursing homes.

1) Community First Choice (CFC) Option – This state plan option provides services that enable a senior to live in their home independently rather than a nursing home facility. Assistance with daily living activities (cooking, light housecleaning, bathing, mobility, etc.), meal delivery, and home modifications, are available benefits.

2) Connecticut Home Care Program for Elders (CHCPE) – Also called the Home and Community Based Services Waiver for Elders, assistance is provided to aid elders in living at home, assisted living, or adult foster care. Benefits may include adult day care, home delivered meals, light housecleaning, minor home modifications, personal care assistance, personal emergency response systems, chore services, and assisted living services. Adult Family Living (AFL), which is similar to adult foster care, is another available benefit in which a senior moves in with a relative or friend (or vice versa) and the senior is provided supervision, personal care assistance, and transportation. AFL may also be called Caregiver Homes of Connecticut.

3) Money Follows the Person (MFP) – This federal program helps institutionalized persons who are eligible for Medicaid to transition back home or into the community.

 

How to Apply for Connecticut Medicaid

Persons can apply for CT long-term care Medicaid online at ConneCT website, download an application, or call the Department of Social Services (DSS) Client Information Line and Benefits Center at 1-855-626-6632 to request a mailed application. Persons can call their local DSS office for additional Medicaid program information or to apply. One’s local Area Agency on Aging office may also be helpful in providing information and application assistance. The application process may vary based on the program for which one is applying.

It is vital that Medicaid applicants be certain that all eligibility requirements are met prior to applying for benefits. Senior CT residents who are over the income and / or asset limit(s), or are unsure, should strongly consider Medicaid Planning for the best chance of acceptance into a Medicaid program. Familiarizing oneself with general information about the Medicaid long-term care application process can be helpful.

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