Mississippi Medicaid Eligibility for Long Term Care: Income & Asset Limits

Last updated: November 21, 2023


Mississippi Medicaid Long-Term Care Definition

Medicaid is a health care program for low-income individuals of all ages. While there are many diverse coverage groups, this webpage covers long-term care Medicaid eligibility for elderly Mississippi residents, aged 65 and over. In addition to nursing home care and assisted living services, Mississippi Medicaid pays for many non-medical support services that help frail seniors remain living at home.

1) Institutional / Nursing Home Medicaid – An entitlement; anyone who is eligible 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 slots and wait lists may exist. Intended to delay nursing home admissions, services and supports are provided at home, adult day care, or in assisted living. More on Waivers.

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

Medicaid is jointly funded by the state and federal government, but is administered by the state under federally set parameters. In Mississippi, the Mississippi Division of Medicaid (DOM) administers the program.

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


Income & Asset Limits for Eligibility

Each of the three Medicaid long-term care programs have varying financial and medical (functional) eligibility criteria. Some financial requirements change annually, vary based on marital status, and is further complicated due to Mississippi offering alternative pathways towards eligibility.

 Simplified Eligibility Criteria: Single Nursing Home Applicant
MS 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 $2,829 / month 2) Assets under $4,000 3) Require a Nursing Home Level of 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, one can take the Medicaid Eligibility TestIMPORTANT: Not meeting all of the criteria below does not mean one is ineligible or cannot become eligible for MS Medicaid. More.

2024 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 $2,829 / month* $4,000 Nursing Home $5,658 / month ($2,829 / month per spouse)* $6,000 Nursing Home $2,829 / month for applicant* $4,000 for applicant & $154,140 for non-applicant Nursing Home
Medicaid Waivers / Home and Community Based Services $2,829 / month† $4,000 Nursing Home $5,658 / month ($2,829 / month per spouse)† $6,000 Nursing Home $2,829 / month for applicant† $4,000 for applicant & $154,140 for non-applicant Nursing Home
Regular Medicaid / Aged Blind and Disabled $943 / month $2,000 Help with ADLs $1,415 / month $3,000 Help with ADLs $1,415 / month $3,000 Help with ADLs
*All of a beneficiary’s monthly income, with the exception of a Personal Needs Allowance of $44 / month, Medicare premiums, and possibly a Needs Allowance for a non-applicant spouse (if applicable), must go towards nursing home costs. This is called a Patient Liability.
†Based on one’s living setting, a beneficiary may not be able keep monthly income up to this level.


Income Definition & Exceptions

Countable vs. Non-Countable Income
Nearly all income that a Medicaid applicant receives is counted towards Medicaid’s income limit. This includes cash from family and friends, employment wages, alimony payments, pension payments, annuity payments, Social Security Disability Income, Social Security Income, IRA withdrawals, and stock dividends. Nationally, Holocaust restitution payments are not counted as income. Furthermore, in MS, the VA Aid & Attendance, 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 HCBS Medicaid Waiver, only the income of the applicant is counted. The non-applicant spouse, however, may be entitled to a monthly Spousal Income Allowance from their applicant spouse. This Spousal Impoverishment Rule is called a Monthly Maintenance Needs Allowance (MMNA) and is the minimum amount of monthly income to which a non-applicant spouse is entitled.

In 2024, the MMNA in MS is $3,853.50. If a non-applicant spouse has monthly income under this amount, income can be transferred to them from their applicant spouse to bring their income up to $3,853.50 / month. A non-applicant spouse who already has income of $3853.50 / month or more is not entitled to a MMNA / Spousal Income Allowance. This transfer of income is also effective in lowering the applicant’s countable income for eligibility purposes.

Income is calculated differently when only one spouse applies for Regular Medicaid (Aged Blind & Disabled); the income of both the applicant and non-applicant spouse is counted towards the applicant’s income eligibility. There is no Minimum Monthly Maintenance Needs Allowance for the non-applicant spouse.  More on how Medicaid counts income.


Asset Definition & Exceptions

Countable vs. Non-Countable Assets
Countable assets are counted towards Medicaid’s asset limit. These non-exempt assets include cash the month after receipt, stocks, bonds, investments, bank accounts (credit union, savings, and checking), pension funds, and real estate in which one does not reside. There are also non-countable (exempt) assets; they do not count towards the asset limit. Exemptions include personal belongings, household goods / furnishings, up to two automobiles, whole life insurance policies with a combined face value up to $10,000, burial spaces, and burial funds up to $6,000. In Mississippi, IRA’s and 401K’s in “payout status” are also exempt. This means that one’s Required Minimum Distribution (RMD) is being withdrawn. One’s primary home is also generally exempt.

Treatment of Assets for a Couple
All assets of a married couple are considered jointly owned. This remains true regardless of the Medicaid long-term care program and regardless of if one or both spouses are applicants. However, there is a Community Spouse Resource Allowance (CSRA) that protects a larger amount of the couple’s assets for the non-applicant spouse of a Nursing Home Medicaid or HCBS Waiver applicant. In 2024, the CSRA allows the community spouse (the non-applicant spouse) to keep up to $154,140 of the couple’s assets. For Regular Medicaid, there is no CSRA for a non-applicant spouse.

Medicaid’s Look-Back Rule
Mississippi has a 60-month Medicaid Look-Back Period, which immediately precedes the date of one’s Nursing Home Medicaid or Medicaid Waiver application. During this period, Medicaid checks all past asset transfers to ensure no assets were sold or gifted under fair market value. This includes asset transfers made by one’s spouse. The Medicaid Look-Back Rule is intended to discourage persons from gifting assets to meet Medicaid’s asset limit. Applicants who violate this rule are penalized with a Penalty Period of Medicaid ineligibility. The Look-Back Period does not apply to Regular Medicaid.

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


Mississippi Medicaid Home Exemption Rules

For the home to be exempt, the Medicaid applicant or their spouse must live in it. If there is no spouse in the home, there is a home equity interest limit of $713,000 (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 in their home, the applicant must have Intent to Return. There is no home equity interest for Regular Medicaid. Other exemptions exist.

While one’s home is usually exempt from Medicaid’s asset limit, it is not exempt from Medicaid’s Estate Recovery Program (MERP). Following a long-term care Medicaid beneficiary’s death, Mississippi’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 Medicaid long-term care. For Nursing Home Medicaid and HCBS Medicaid Waivers, a Nursing Facility Level of Care (NFLOC) is required. Furthermore, certain benefits may have additional eligibility requirements specific to that benefit. For example, for a Waiver to cover the cost of home modifications, an inability to safely live independently without modifying the home might be required. For long-term care services via the Regular Medicaid program, a functional need with the Activities of Daily Living is required, but a NFLOC is not necessarily required.


Qualifying When Over the Limits

For Mississippi elderly residents (aged 65 and over) who do not meet the financial eligibility requirements above, there are other ways to qualify for Medicaid.

1) Qualified Income Trusts (QIT’s) – Also called Miller Trusts, or specific to Mississippi, Income Trusts, these special trusts offer a way for Medicaid applicants who are over the income limit to become income-eligible for Nursing Home Medicaid or a Medicaid Waiver. Income 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 the 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. The Mississippi Division of Medicaid must be listed as the remainder beneficiary. In addition, account funds can only be used for very specific purposes, such as paying long-term care services / medical expenses accrued by the Medicaid enrollee. Annually, any excess funds that remain in the Income Trust must be paid to the State of Mississippi.

2) Asset Spend Down – Persons who have assets over MS Medicaid’s limit can “spend down” excess assets on non-countable ones to become asset-eligible. Examples include 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. 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.

3) Medicaid Planning – The majority of persons considering Medicaid are “over-income” and / or “over-asset”, but they still cannot afford their cost of care. For these individuals, Medicaid planning exists. By working with a Medicaid Planning Professional, families can employ a variety of strategies to help them become Medicaid eligible, as well as to protect their home from Medicaid Estate Recovery. Connect with a Medicaid Planner.


Specific Mississippi Medicaid Programs

In addition to paying for nursing home care, Medicaid in Mississippi offers three programs relevant to the elderly that helps them to remain living in their homes or in assisted living residences.

1) Assisted Living (AL) Waiver – While this 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 via this Waiver enable seniors and individuals with disabilities to continue to live at home and in the community. Benefits may include adult day care, meal delivery, personal care assistance, and transitional services from living in a nursing facility to one’s home.


How to Apply for Mississippi Medicaid

To apply for Medicaid in MS, seniors can apply online at AccessMS or download the “Application for Mississippi Medicaid Aged, Blind and Disabled Medicaid Programs”. Alternatively, persons can call the Office of Eligibility at the Division of Medicaid at 800-421-2408 to request a mailed application. The Office of Eligibility can also answer questions regarding program requirements and the application process. Completed applications should be submitted to one’s Division of Medicaid regional office in-person or by mail. See office locations and contact information. Alternatively, seniors can fax their completed application to the Office of Eligibility at 601-576-4164. The application process may vary based on the program for which one is applying. Furthermore, an in-person interview may be required as part of the application process.

Mississippi Medicaid applicants should be certain that they meet all financial eligibility requirements prior to submitting an application for benefits. Seniors who are uncertain if they meet the criteria or have income and / or assets in excess of the limit(s), should strongly consider Medicaid planning. Applying for Medicaid can be a complicated and drawn out process.  Learn more about the application process for long-term care Medicaid.

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