Mississippi Medicaid Definition
In Mississippi, the Mississippi Division of Medicaid (DOM) is the agency that administers the state’s Medicaid program.
Medicaid is a wide-ranging, jointly funded state and federal health care program for low-income individuals of all ages. While there are a several different eligibility groups, the focus of this page is strictly on Medicaid eligibility for elderly Mississippi residents, aged 65 and over. In addition, the focal point will be specifically Medicaid for long term care, whether that is at home, in a nursing home, or in an assisted living facility.
Income & Asset Limits for Eligibility
There are several different Medicaid long-term care programs for which Mississippi seniors may be eligible. These programs have slightly different financial and medical (functional) eligibility requirements, as well as varying benefits. Further complicating eligibility are the facts that the criteria vary with marital status and that Mississippi offers several pathways towards eligibility.
1) Institutional / Nursing Home Medicaid – is an entitlement (anyone who is eligible will receive assistance) program & is provided only in nursing home facilities.
2) Medicaid Waivers / Home and Community Based Services (HCBS) – Limited number of participants, which means wait lists may exist. Services are provided at home, adult day care, or in assisted living.
3) Regular Medicaid / Aged Blind and Disabled (ABD) – is an entitlement (anyone who meets the requirements is able to receive benefits) program. Services are available at home or adult day care.
The table below provides a quick reference to allow seniors to determine if they might be immediately eligible for long term care from a Mississippi Medicaid program. Alternatively, take the Medicaid Eligibility Test. IMPORTANT, not meeting all the criteria below does not mean one is not eligible or cannot become eligible. More.
|2018 Mississippi 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||$2,250 / month||$4,000||Nursing Home||$4,500 / month (Each spouse is allowed up to $2,250 / month)||$8,000 (Each spouse is allowed up to $4,000)||Nursing Home||$2,250 / month for applicant||$4,000 for applicant & $123,600 for non-applicant||Nursing Home|
|Medicaid Waivers / Home and Community Based Services||$2,250 / month||$4,000||Nursing Home||$4,500 / month (Each spouse is allowed up to $2,250 / month)||$8,000 (Each spouse is allowed up to $4,000)||Nursing Home||$2,250 / month for applicant||$4,000 for applicant & $123,600 for non-applicant||Nursing Home|
|Regular Medicaid / Aged Blind and Disabled||$750 / month||$4,000||None||$1,125/ month||$6,000||None||$750 / month||$4,000||None|
What Defines “Income”
For Medicaid eligibility purposes, any income that a Medicaid applicant receives is counted. To clarify, this income can come from any source. Examples include cash from family and friends, Veteran’s benefits, employment wages, alimony payments, pension payments, annuity payments, Social Security Disability Income, Social Security Income, IRA withdrawals, and stock dividends. However, when only one spouse of a married couple is applying for Medicaid, only the income of the applicant is counted. Said another way, the income of the non-applicant spouse is disregarded. There is also a Minimum Monthly Maintenance Needs Allowance (MMMNA), which is the minimum amount of monthly income to which the non-applicant spouse is entitled. Some states use a minimum and maximum figure, but the state of Mississippi uses a standard figure of $3,090 / month. (This figure will change in January of 2019). This rule allows the Medicaid applicant to transfer income (up to $3,090 / month) to the non-applicant spouse to ensure he or she has sufficient funds with which to live. In addition, this transfer of income is effective in lowering the applicant’s countable income for eligibility purposes.
What Defines “Assets”
Countable assets are assets that can easily be converted to cash to help cover the cost of long-term care and include the following: Cash, stocks, bonds, investments, credit union, savings, and checking accounts, pension funds, and real estate in which one does not reside. However, for Medicaid eligibility, there are many assets that are considered exempt, or said another way, non-countable. Exemptions include personal belongings, household goods / furnishings, an automobile, whole life insurance policies (up to a combined face value of $10,000), burial plots, burial funds (up to $6,000), and one’s primary home, given the Medicaid applicant or their spouse lives in the home and the home is valued under $572,000 (in 2018). For married couples, as of 2018, the community spouse (the non-applicant spouse) can retain up to a maximum of $123,600 of the couple’s joint assets, as the chart indicates above. This, in Medicaid speak, is known as the Community Spouse Resource Allowance (CSRA).
One should be aware that Mississippi has a Medicaid Look-Back Period. This is a period of 60 months (5 years) that dates back from the date of one’s Medicaid application. During this time frame, Medicaid checks all past asset transfers to ensure no assets were sold or given away under fair market value. This is done so one does not simply give away assets in order to meet Medicaid’s asset limit. If one is found to be in violation of the look-back period, a period of Medicaid ineligibility will result.
Qualifying When Over the Limits
For Mississippi elderly residents (65 and over), who do not meet the eligibility requirements in the table above, there are other ways to qualify for Medicaid.
1) Qualified Income Trusts (QIT’s) – QIT’s, also referred to as Miller Trusts, are special trusts for Medicaid applicants who are over the income limit but still cannot afford to pay for their long-term care. (For Mississippi Medicaid purposes, a Miller Trust is often simply called an Income Trust.) This type of trust offers a way for individuals over the Medicaid income limit to still qualify for long-term care Medicaid, as money deposited into a QIT does not count towards Medicaid’s income limit. In simple terms, one’s excess income (over the Medicaid Cap) is directly deposited into a trust, in which a trustee is named, giving that individual legal control of the money. The account must be irreversible, meaning once it has been established, it cannot be changed or canceled, and must have Mississippi Division of Medicaid listed as the remainder beneficiary. In addition, the money in the account can only be used for very specific purposes, such as paying long term care services / medical expenses accrued by the Medicaid enrollee. As previously stated, the income in this account is exempt from Medicaid’s income limit.
Unfortunately, Income Only Trusts do not assist one in qualifying for Medicaid if their assets are over the limit. Said another way, if one meets the income requirements for Medicaid eligibility, but not the asset requirement, the above option cannot assist one in reducing their extra assets. However, one can “spend down” assets by spending excess assets on non-countable assets, such as home modifications (wheelchair ramps, roll-in showers, and stair lifts), home improvements (replacing faulty electrical wiring, updating plumbing, and replacing old water heaters), vehicle modifications (wheelchair lifts, adaptive control devices, and floor modifications to allow one to drive from a wheelchair), prepaying funeral and burial expenses, and paying off debt.
2) Medicaid Planning – the majority of persons considering Medicaid are “over-income” or “over-asset” or both, but still cannot afford their cost of care. For persons in this situation, Medicaid planning exists. By working with a Medicaid planning professional, families can employ a variety of strategies to help them become Medicaid eligible. Read more or connect with a Medicaid planner.
Specific Mississippi Medicaid Programs
1) Assisted Living (AL) Waiver – While this home and community based services waiver does not provide financial assistance for the room and board portion of assisted living facilities, it does provide assistance in the form of supportive services. Benefits in assisted living communities may include attendant care, homemaker services, medication management, and temporary skilled nursing services.
2) Independent Living (IL) Waiver – Intended for individuals with neurological or orthopedic impairments who require a nursing facility level of care, this waiver provides services in the home and community for a variety of diagnoses, including Alzheimer’s disease and other related dementias. Home modifications, personal care assistance, and specialized medical equipment are available through this program.
3) Elderly and Disabled (E&D) Waiver – Supportive services to delay and prevent nursing home admissions are available for seniors and disabled individuals via this waiver. Benefits may include adult day care, meal delivery, personal care assistance, and transitional services from living in a nursing facility to one’s home.