An overview of Medicaid “spend down”
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An overview of Medicaid “spend down”

| Oct 29, 2019 | Firm News |

As you get older, needing a way to pay for your future health needs may weigh on your mind. Can you afford nursing care without outside help? 

The cost of nursing home care is on the rise. In West Virginia, it costs upward of $274 a day. Medicaid, a federal program, gives you the option to help pay for this, but there is the possibility that you make too much to be eligible. What do you do now? 

Applying for Medicaid 

The West Virginia Medicaid program provides qualified residents with access to medical care. This allows those who cannot afford medical care the opportunity to get it. Medicaid’s eligibility requirements include: 

  • Children under 21 
  • Adults over 65 
  • A person disabled or blind 
  • At least one deceased, disabled or unemployed parent 

Coverage can start three months before approval. But there is no guarantee as to how long the application process will take. 

Medicaid spend down 

To be eligible for long-term care, you must have income and assets under a certain amount. If your finances exceed this amount, you can still become eligible by lowering them. Medicaid calls this “spend down.” 

If you want approval for nursing home services, West Virginia’s Medicaid Program provides two options with limitations on income and assets: 

  1. Institutional and Nursing Home Medicaid is an entitlement program that uses the benefits only for nursing home facilities. As an individual, your income limit is $2,313 a month, with assets of no more than $2,000.
  2. Medicaid Waivers and Home and Community Based Services are for services provided in a home, adult daycare or assisted living. For one person, the limit on income is $2,313, with an asset limitation of $2,000.

Assets are either exempt or nonexempt. An exempt asset is your home. Nonexempt assets, also known as liquid assets, count. These can include bank accounts and property other than the primary residence. 

Income levels depend on who is applying for Medicaid. If one spouse is applying, then only that person’s income counts. Speaking with an attorney experienced in the Medicaid program may help you understand the eligibility requirements.