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

Last updated: December 15, 2021

 

Mississippi  Medicaid Definition

In Mississippi, the Mississippi Division of Medicaid (DOM) 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 several different eligibility groups, this webpage covers Medicaid eligibility for elderly Mississippi residents, aged 65 and over. Specifically, it focuses on Medicaid long-term care. 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.

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

 

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) criteria, 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 – This is an entitlement program; Anyone who is eligible will receive assistance. Benefits are provided only in nursing home facilities.

2) Medicaid Waivers / Home and Community Based Services (HCBS) – This is not an entitlement program; There are a limited number of participant slots and wait lists may exist. Intended to delay nursing home admissions, services are provided at home, adult day care, or in assisted living. More about Medicaid Waivers here.

3) Regular Medicaid / Aged Blind and Disabled (ABD) – This is an entitlement program; 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.

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 the criteria below does not mean one is ineligible or cannot become eligible for MS Medicaid. More.

2022 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 $2,523 / month* $4,000 Nursing Home $5,046 / month ($2,523 / month per spouse)* $8,000 ($4,000 per spouse) Nursing Home $2,523 / month for applicant* $4,000 for applicant & $137,400 for non-applicant Nursing Home
Medicaid Waivers / Home and Community Based Services $2,523 / month $4,000 Nursing Home $5,046 / month ($2,523 / month per spouse $8,000 ($4,000 per spouse) Nursing Home $2,523 / month for applicant $4,000 for applicant & $137,400 for non-applicant Nursing Home
Regular Medicaid / Aged Blind and Disabled $841 / month $2,000 Help with ADLs $1,261 / month $3,000 Help with ADLs $1,261 / 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 a monthly spousal income allowance (if applicable), must go towards nursing home costs.

 

What Defines “Income”

For Medicaid eligibility purposes, any income that a Medicaid applicant receives is counted. 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. Holocaust restitution payments, VA Aid & Attendance pension benefits, and Covid-19 stimulus checks are not considered income and do not impact Medicaid eligibility.

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. This means the income of the non-applicant spouse does not impact the income eligibility of the applicant. 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 Minimum Monthly Maintenance Needs Allowance (MMMNA) and is intended to prevent the non-applicant spouse from living in poverty. In 2022, the MMMNA is $3,435. If a non-applicant spouse has monthly income under this amount, income can be transferred from the applicant spouse to the non-applicant spouse to bring their monthly income up to this level. A non-applicant spouse who already has income of $3,435 / month or more is not entitled to a MMMNA / 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 spouse and non-applicant spouse is calculated towards the applicant’s income eligibility. More on how Medicaid counts income for eligibility purposes.

 

What Defines “Assets”

Countable assets are ones that can easily be converted to cash to help cover the cost of long-term care. This includes cash, stocks, bonds, investments, credit union, savings, and checking accounts, pension funds, and real estate in which one does not reside. There are also many assets that are exempt, which means they do not count towards Medicaid’s 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 plots, burial funds up to $6,000, and generally one’s primary home. For the home to be exempt, the Medicaid applicant must live in it or have intent to return and have a home equity interest under $636,000 (in 2022). Equity interest is the value of the home in which the applicant owns minus any debt against it. The home is exempt, regardless of the above circumstances, if a non-applicant spouse lives in it.

 While one’s home is usually 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, 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.

All assets of a married couple are considered jointly owned regardless of the Medicaid long-term care program for which one is applying. However, the non-applicant spouse of a nursing home Medicaid or HCBS Waiver applicant is permitted a Community Spouse Resource Allowance (CSRA). In 2022, the community spouse (the non-applicant spouse) can keep up to $137,400 of the couple’s assets, as indicated in the chart above.

Mississippi has a 60-month (5 year) Medicaid Look-Back Period, which immediately precedes 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 to prevent persons from giving away assets to meet Medicaid’s asset limit. If one violates the look-back period, a period of Medicaid ineligibility will result.

 Non-Financial Eligibility Requirements – For long-term care Medicaid in Mississippi, an applicant must have a functional need. 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 (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) – 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 still qualify for nursing home Medicaid or a Medicaid Waiver. 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 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.

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 the look back period was not violated.

3) 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 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. 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 via this Waiver enable seniors and disabled individuals 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 download the “Application for Mississippi Medicaid Aged, Blind and Disabled Medicaid Programs” here. 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. For office locations and contact information, click here. Alternatively, seniors can fax their completed application to the Office of Eligibility at 601-576-4164. Currently, there is no online application for elderly residents of Mississippi seeking aged, blind and disabled Medicaid programs. An in-person interview may be required as part of the application process.

Mississippi Medicaid applicants should be certain that they meet all eligibility requirements, which are covered in detail above, 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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