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

Last updated: November 27, 2023

 

Wyoming Medicaid Long-Term Care Definition

Medicaid is a health insurance program for low-income individuals of all ages. While there are varying coverage groups, this page is focused on long-term care Medicaid eligibility for Wyoming elders, aged 65 and over. In addition to nursing home care, WY Medicaid pays for many non-medical support services that help frail seniors remain living in their homes, in adult foster care, or in assisted living. There are three categories of Medicaid long-term care programs for which Wyoming 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 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, or in assisted living. More about Waivers.

3) Regular Medicaid / Aged, Blind, and Disabled – An entitlement; all eligible applicants are able to receive services. Various long-term care benefits, 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 within federally set parameters. The Wyoming Department of Health 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 long-term care Medicaid programs have varying financial and medical (functional) eligibility requirements. Further complicating eligibility is that the financial requirements change annually, vary with marital status, and that Wyoming offers several pathways towards Medicaid eligibility.

 Simplified Eligibility Criteria: Single Nursing Home Applicant
Wyoming 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 $2,000 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 Wyoming 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 WY Medicaid.  More.

2024 Wyoming 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* $2,000 Nursing Home $5,658 / month ($2,829 / month per spouse)* $3,000 Nursing Home $2,829 / month for applicant* $2,000 for applicant & $154,140 for non-applicant Nursing Home
Medicaid Waivers / Home and Community Based Services $2,829 / month† $2,000 Nursing Home $5,658 / month ($2,829 / month per spouse)† $3,000 Nursing Home $2,829 / month for applicant† $2,000 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 $50 / month Personal Needs Allowance, Medicare premiums, and possibly a Needs Allowance for a non-applicant spouse, must be paid to the nursing home. This is called a Patient Liability.

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

 

Income Definition & Exceptions

Countable vs. Non-Countable Income
Nearly any income that a Medicaid applicant receives is counted towards Medicaid’s income limit. Countable income includes 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 WY, 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 Medicaid Waiver, only the income of the applicant is counted towards income eligibility. Furthermore, the non-applicant spouse may be entitled to a Minimum Monthly Maintenance Needs Allowance (MMMNA) from their applicant spouse. The MMMNA is the minimum amount of monthly income a non-applicant spouse is said to require to avoid spousal impoverishment.

In 2024, the MMMNA in WY is $3,853.50 / month. If a non-applicant spouse has monthly income under this amount, income can be transferred to them from their applicant spouse to bring their monthly income up to this level. A non-applicant spouse who already has $3,853.50 / month or more in income is not entitled to a MMMNA / Spousal Income Allowance.

Income is counted differently when only one spouse applies for Regular Medicaid; the income of both the applicant and non-applicant spouse is calculated towards the applicant’s income eligibility. There is no Minimum Monthly Maintenance Needs Allowance for the non-applicant spouse. Learn more about how Medicaid counts income.

 

Asset Definition & Exceptions

Countable vs. Non-Countable Assets
Countable assets, also called resources, are counted towards Medicaid’s asset limit. This includes cash, stocks, bonds, investments, promissory notes, certificates of deposit, bank accounts (credit union, savings, checking), and real estate in which one does not reside. In Wyoming, an applicant’s IRA / 401K is counted. There are also many assets that are not counted towards Medicaid’s asset limit. These non-countable (exempt) assets include personal belongings, such as clothing and wedding rings, household furnishings and appliances, an automobile, a burial plot, burial funds (up to $1,500), life insurance policies (up to $1,500 in cash surrender value), and generally one’s primary home. In WY, a non-applicant spouse’s IRA / 401K is not counted.

Treatment of Assets for a Couple
The assets of a married couple are considered to be 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, the non-applicant spouse of a Nursing Home Medicaid or Medicaid Waiver applicant is permitted a larger portion of the couple’s assets. This is called a Community Spouse Resource Allowance (CSRA). In 2024, this Spousal Impoverishment Rule allows the community spouse (the non-applicant spouse) to keep up to $154,140 of the couple’s assets.

Medicaid’s Look-Back Rule
Wyoming has a 60-month (5 year) Medicaid Look-Back Period that immediately precedes the date of one’s Nursing Home Medicaid or Medicaid Waiver application.

During which, the Medicaid agency checks all past asset transfers to ensure none were gifted or sold for less than fair market value. This includes transfers made by one’s non-applicant spouse. If one has violated the “look back”, it is assumed it was done to meet Medicaid’s asset limit and they will be penalized with a period of Medicaid ineligibility. The Look-Back Rule does not apply to 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.

 

Wyoming Medicaid Home Exemption Rules

For home exemption, the Medicaid applicant or their spouse must live in their home. 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 it, 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 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, Wyoming’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

A long-term care Medicaid applicant must have a medical need for such care. For Nursing Home Medicaid and Medicaid Waivers, a Nursing Facility Level of Care (NFLOC) is required. Some program benefits, such as personal emergency response systems, may have additional eligibility criteria. For instance, the inability to safely live at home without this system may be necessary. For long-term care services via the Regular Medicaid program, a functional need with the Activities of Daily Living (ADLs) is required, but a NFLOC is not necessarily required.

 

Qualifying When Over the Limits

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

1) Qualified Income Trusts (QIT’s) – Also called Miller Trusts, and specifically Irrevocable Income Trusts in Wyoming, these special trusts offer a way for individuals over the Medicaid income limit to still become income-eligible 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 income limit) is directly deposited into the irrevocable trust, in which a trustee is named, giving that individual legal control of the money. Irrevocable means the terms of the trust cannot be changed or canceled. The trust funds can only be used for very specific purposes, such as paying long-term care services / medical expenses accrued by the Medicaid enrollee. The state of Wyoming must be listed as the remainder beneficiary.

2) Asset Spend Down – Persons who have assets over Medicaid’s limit can “spend down” excess assets on non-countable ones and become asset-eligible. Examples include home modifications and additions (wheelchair ramps, roll-in showers, stair lifts, and adding first floor bedrooms), 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. One must be cautious when “spending down” assets to avoid violating 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 persons, 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 Wyoming Medicaid Programs

In addition to paying for nursing home care, Wyoming Medicaid offers the following program relevant to the elderly that helps them to remain living at home and in their community.

1) Community Choices Waiver (CCW) – This HCBS Medicaid Waiver provides assistance for those who require a Nursing Home Level of Care, but choose to remain living at home, the home of a family member, an adult foster care home, or in an assisted living facility. Benefits include adult day care, meal delivery, personal emergency response systems, respite care, skilled nursing, and non-medical transportation. Personal care attendants are also an available benefit, and via the In-Home Participant Directed Option, program participants can hire the caregiver of their choosing, including select relatives.

 

How to Apply for Wyoming Medicaid

Seniors can apply for Medicaid benefits online at the WY Medicaid/CHIP Web Portal, by submitting a completed Application for Health Coverage & Help Paying Costs, or by calling the Customer Service Center at 1-855-294-2127. The application process may vary based on the program for which one is applying. The Aging & Disability Resource Center might be helpful in answering questions or providing application assistance. Once an application is submitted, it may take as long as 45 days for Medicaid to determine if one is eligible.

When submitting an application for long-term care Medicaid in Wyoming, it is vital that applicants are certain that they meet all eligibility criteria. Elderly applicants who have income and / or assets over the limit(s) should consider Medicaid Planning for the best chance of acceptance into a Medicaid program. While the application process can be confusing and lengthy, seniors can learn more about the process here.

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