Medicaid Asset & Income Rules
Medicaid Asset & Income Rules
Our experienced Medicaid Planning attorney at the Dobson Law Group provides comprehensive estate planning services including guidance on Medicaid asset rules and Medicaid income rules, Medicaid Planning and eligibility to individuals and their families in Greenville and throughout the Upstate of South Carolina. The federal and state laws governing South Carolina Medicaid program Healthy Connections and the Medicaid asset and income rules continue to change and are far more complicated than what most people anticipate.
Plan Now, Medicaid Planning Protects Assets & Addresses Medicaid Eligibility
Medicaid pays for the cost of Nursing Home care in South Carolina that meet certain financial and health criteria. The average cost of Skilled Nursing Care in South Carolina is $72,636, so securing Medicaid coverage is essential. In South Carolina, there are 189 Nursing Homes, of which 81% accept Medicaid insurance as a form of payment. The most expensive Nursing Home in South Carolina is GHS Laurens County Memorial Subacute Unit which costs $911 per day and the least expensive Nursing Home is C M Tucker Nursing Care Center / Roddey which costs $101 per day. Nursing Homes in South Carolina are currently 86.12% full of 16,881 patients currently using the 19,601 beds available. (source: http://familyassets.com)
The South Carolina Medicaid program, Healthy Connections, along with the federal laws, provides individuals and their families with specific legal and financial requirements and regulations for Medicaid eligibility, assets and income treatment, transfers of assets and community spousal income. Our experienced Medicaid Benefits Planning attorney at the Dobson Law Group understands the complexities of the Medicaid program, changes to the federal and South Carolina laws and the Medicaid asset and income rules.
We help our clients design, develop and implement integrated legal and financial strategies that utilize Medicaid benefits to pay for long-term nursing home care while protecting assets and preserving their wealth. Contact our experienced Medicaid Planning attorney today to obtain with every step in the process.
2018 South Carolina Medicaid Nursing Home and Long Term Care Guidelines
|Medicaid Eligibility Requirement||Single||Married|
|2018 South Carolina Medicaid Income Limits||$2,250||$2,250|
|2018 South Carolina Medicaid Asset Limits||$2,000||$2,000|
|2018 South Carolina Medicaid Home Equity Limit||$572,000||$572,000|
|2018 South Carolina Community Spouse Resource Allowance||$66,480||$66,480|
Noncountable assets include:
- The value of one automobile;
- The value of life estate interest in real property;
- Personal possessions, such as clothing, furniture, and jewelry
- The value of undivided interest in heirs property; and
- The applicant’s principal residence, provided it is in the same state in which the individual is applying for coverage (the states vary in whether the Medicaid applicant must prove a reasonable likelihood of being able to return home). Principal residences may be deemed noncountable only to the extent their equity is less than $572,000 (2018). If the applicants’ spouse or other dependent resides in the house it may be kept.
- The cash value of life insurance policies owned by the individual when the total face value of all policies is $10,000 or less.
- Up to $1,500; and set aside for the individual’s burial. (An additional $1,500 for a spouse, if living)
- Assets that are considered “inaccessible” for one reason or another
If a gift of any amount is given in South Carolina during a period of 5 years before applying to Medicaid, a penalty period will be initiated. This penalty period in South Carolina is called a look-back period and it can make an individual not eligible for Medicaid. Medicaid will not pay for care until the penalty period is over. The penalty is calculated by taking the total amount of any gifts given and dividing it by $6,672, which creates a number of months before Medicaid kicks in.
The average cost of Nursing home care in South Carolina is $6,596, so penalties can become very costly for a family that has not planned appropriately for Medicaid.
The following represent exemptions in the transfer of assets:
- A spouse (or a transfer to anyone else as long as it is for the spouse’s benefit)
- A blind or disabled child
- A trust for the sole benefit of a disabled individual under age 65 (under certain circumstances it may be for the benefit of the Medicaid applicant,).
In addition, special exceptions apply to the transfer of a home. The applicant may transfer their home to the following without penalty:
- The applicant’s spouse
- A child who is under age 21 or who is blind or disabled
- Into a trust for the sole benefit of a disabled individual under age 65 (even if the trust is for the benefit of the Medicaid applicant, under certain circumstances)
- A sibling who has lived in the home during the year preceding the applicant’s institutionalization and who already holds an equity interest in the home
- A “caretaker child,” who is defined as a child of the applicant who lived in the house for at least two years prior to the applicant’s institutionalization and who during that period provided care that allowed the applicant to avoid a nursing home stay.
If you are married and applying for Medicaid, your eligibility is determined in part by your and your spouse’s “countable assets,” broadly defined as anything that could potentially be used to pay for medical care (for example, money in your savings account). These assets must be below a certain threshold in order for you to qualify for Medicaid.
However, both you and your spouse are entitled to keep a certain amount of these assets, protecting them from Medicaid consideration. As the spouse applying for Medicaid (the “Institutionalized Spouse”), you are entitled to hold $2,000 in countable assets. As the “Community Spouse” (the spouse not applying for Medicaid), your husband or wife is entitled to hold an amount that varies by state, called the “Community Spouse Resource Allowance.”
The Community Spouse Resource Allowance, or “CSRA,” is the amount of countable assets your spouse is allowed to hold without disqualifying you from Medicaid.
For Medicaid eligibility purposes, all assets held by you or your spouse or jointly are considered, regardless of the name in which they’re held or any prenuptial or postnuptial agreements.
In other words, to qualify for Medicaid, you and your spouse’s total countable assets must be less than the CSRA (your spouse’s maximum) plus $2,000 (your maximum).
South Carolina Community Spouse Resource Allowance
Your CSRA is determined by both federal and state rules. The federal government sets a nationwide maximum CSRA ($123,600 in 2018, updated annually) and South Carolina is a “100% state meaning your spouse can keep 100% of your combined countable assets up to the federal maximum of $123,600. So if you and your spouse have a total of $100,000 in countable assets (bank accounts, stocks, etc.) at the time of your Medicaid application, then you are within the CSRA limit and are already eligible for Medicaid (assuming you otherwise qualify).
But if you and your spouse have a total of $150,000 in countable assets, you would need to spend or otherwise convert the “excess assets” (the amount over the maximum allowed) before becoming eligible. In this example, your excess assets would be $24,400, because: $150,000 in total countable assets – $2,000 allowed for you – $123,600 allowed for your spouse = $24,400.
Under Medicaid law, following the death of the Medicaid recipient a state must attempt to recover from his or her estate whatever benefits it paid for the recipient’s care. However, no recovery can take place until the death of the recipient’s spouse, or as long as there is a child of the deceased who is under age 21 or who is blind or disabled.
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Plan Now, Consult a South Carolina Medicaid Planning Lawyer in Greenville SC
Our Medicaid planning attorney can assist you in developing a custom-tailored strategy to enable you to qualify for Medicaid benefits to pay for long-term nursing home care while preserving your assets. Don’t wait to plan, contact a Medicaid Planning attorney at the Dobson Law Group to discuss your options and requirements today at (864)271-8171 or online to schedule an initial consultation.
The Dobson Law Group provides Medicaid Planning & Eligibility legal services to clients in Greenville County and throughout South Carolina including Abbeville, Anderson, Cherokee, Greenwood, Laurens, Lexington, Newberry, Oconee, Pickens, Richland, Spartanburg, and Union County. We are licensed in South Carolina, North Carolina, Florida, and Georgia.