By: Barbara Ellington-Lofton
You may have read my articles in Healthy Cells for several years. If so, you know they usually address issues of long-term care Medicaid. Because I work with Bedford Care Centers, my articles are about nursing homes – admission, benefits, where to begin, and what to expect.
Would you be shocked to learn that Mississippi Medicaid covers much more than nursing home care? Nursing home income and asset limits are usually much more liberal than those for at home Medicaid. But today we’ll see that there are some Medicaid programs that cover individuals living at home and are just as liberal in income and asset requirements. And some individuals who continue to work can be covered while remaining in the workforce.
Over 40 years ago, a program was established to provide Medicaid benefits and some additional services to a group of individuals who could qualify for Medicaid in a nursing home, but chose to remain at home. Initially these were offered only to those who qualified for Supplemental Security Income (SSI). Through the years both income and asset limits have increased, and now are the same as those for nursing home residents. These are the MS Medicaid Home and Community Based Service (HCBS) waivers. There are waivers for the Elderly and Disabled, Assisted Living, Independent Living, Intellectual Disability/Developmentally Disabled waiver, and the Traumatic Brain/Spinal Cord Injury patients. They require being age 65 or older, or with a level of disability that is the same as that for Social Security or SSI, and needing a nursing home or institutional level of care, but electing to remain in a private living arrangement. These waivers can serve a limited number of individuals at any one time, resulting in waiting lists, some as long as 2 years, and some longer. But once accepted into the waiver and approved for Medicaid, services such as personal care attendant services, assistance with bathing and dressing, and assistance with other ADL’s (assistance with daily living) can be provided as a service covered by Medicaid.
Another program is the Disabled Child Living at Home. This program came about as a federal requirement that allows children who would qualify for care in a hospital, nursing home, or other institutional setting, to qualify for Medicaid at home without consideration of parental income or assets. The child must be under age 21, meet the Social Security definition of disability, and meet the requirement for care in a nursing home or other institution. Federal law also requires that children under age 21 who qualify for Medicaid be provided expanded benefits that are medically necessary, whether or not they are covered by the Medicaid state plan. Of course, these expanded benefits can be difficult to access, and many time advocacy groups can assist in this process.
In July 1999 the MS State Legislature instituted a program to allow individuals who work in spite of disabilities to be covered by Medicaid. The basic eligibility requirements for the Working Disabled Program are that the individual work at least 40 hours per month at some paid activity. The paid activity does not have to be one that produces a paycheck (but all wages should be reviewed for federal and state tax requirements). The person must also meet the definition of disability set by the Social Security Administration for Social Security disability and/or SSI, except for meeting the provision of Substantial Gainful Activity. The earned income limit is 250% of the Federal Poverty Level and the unearned income limit is 135% of the Federal Poverty Level. The countable asset limit is $24,000 for an individual and $26,000 for a couple. Some assets, such as a home, one car, and some retirement accounts, are not countable.
Mississippi Medicaid has 40 + Categories of Eligibility. The Medicaid Regional Office is charged with determining which category will be most beneficial for you, provided all technical factors are met. The Medicaid website, www.medicaid.ms.gov, provides information and flyers about different categories, income and asset limits, and benefits offered.
When you hear “Medicaid,” my hope is that you now know that Medicaid offers many categories with different income and asset rules, and varied benefits and services.
Barbara Ellington-Lofton is a Resident Benefits Specialist for Bedford Care Centers. She can be reached by phone at 601-450-3744 or e-mail at firstname.lastname@example.org..