Medical Assistance eligibility is determined by both federal and state law. The dollar amounts used in this Tip Sheet change each January and July. Additional changes may be made as laws are amended.

Always check with your county human services department to make sure you have the most current information about the eligibility rules.

When does Medical Assistance pay for nursing home care?
MA helps pay for nursing home costs if you have limited income and assets. There are special provisions for married couples when one spouse lives in a nursing home and the other spouse lives at home.

Am I able to keep any of my income?
As of Jan. 1, 1999, you are allowed to keep $65 of your monthly income for personal needs. (If you are a veteran, a veteran’s spouse, or if you have work income, the personal needs allowance may be a larger amount).

All of the rest of your income is paid to the nursing home unless:

• you have to pay a guardian or conservator or

• you have a spouse or a dependent family member at home who needs income.

If you have a spouse at home, after the $65 per month has been set aside for your personal needs, your spouse at home can receive a contribution from your income to bring his or her income up to $1,357 per month. Also, if your spouse’s shelter costs are more than $407 per month, the income allowance can be raised by the amount in excess of $407 to a maximum of $2,049 per month. Other dependent family members living at home may also keep some of your income.

Does my spouse have to spend his income on my nursing home care?
No. Income in the "community" spouse’s name is not considered available to pay for your care in the nursing home as of the day you enter the nursing home.

What about my other resources – like my house?
Your home will not be counted as a resource for the first six months of your nursing home stay. It also will not be counted after that as long as you can reasonably be expected to return home and you can show that the cost of care you will receive at home will be covered by MA or another source. Your home does not count as a resource if a spouse or dependent family member lives in the home.

Other resources that you may keep include:

• household goods;

• clothing;

• jewelry;

• burial space items such as a grave marker, gravesite, crypt, mausoleum, vault, casket, urn or other repository;

• a burial account up to $1,500;

• interest accrued on a burial account and burial space items;

• a motor vehicle with a retail value up to $4,500 (can be of greater value if meets MA standards of necessity); and

• up to $3,000 in other assets.

What resources can my spouse keep at home?
This varies depending on the year you entered the nursing home and the year application is made for MA.

If you entered a nursing home on or after Oct. 1, 1989 and applied for MA between Jan. 1, 1998 and Dec. 31, 1998, your spouse at home may keep the greater of $22,828 or one-half of all of the countable assets owned by either you or your spouse (jointly or separately) up to a maximum of $80,760.

If you entered a nursing home on or after Oct. 1, 1989 and apply for MA on or after Jan. 1, 1999, your spouse at home may keep the greater of $23,171 or one-half of all of the countable assets owned by you and your spouse up to $81,960.

How do we figure out how much resources my spouse at home can keep?
At the time you enter the nursing home, you and your spouse should request an "asset assessment" from your county social service agency. This assessment determines which assets may be kept by each of you. If an assessment is done later, you may have spent assets to pay for your care which could have been kept.

Can I transfer my property and still get Medical Assistance?
Transferring property or "gifting" money could make you ineligible for MA for a certain period of time.

This policy does not apply to gifts or transfers made 36 months before the MA application (60 months for certain transfers into trusts). Gifts or transfers made on or after April 13, 1996 for less than $500 in total value for a month will be "disregarded" and will not result in a penalty. However, if the amount transferred in a given month is greater than $500 the entire amount of the transfers will be counted and there will be no disregards. Also, transfers of $500 or less will be added to the value of any earlier transfers if the $500 or less is given away during a month in an existing period of ineligibility.

How long will the penalty period last?
It depends upon the value of the assets transferred. To determine the penalty period, the uncompensated value of the transferred assets is divided by the average cost of nursing home care in effect at the time you apply for MA ($3,134 per month as of July 1, 1998).

What assets do not count?
Currently, exempt resources (see list above) – except for the homestead – can be transferred without penalty. The homestead is not considered an exempt resource for transfer purposes.

Can a homestead ever be transferred without penalty? Yes. A homestead can be transferred without penalty to the following people:

• a spouse;

• a child under 21 or a child of any age who is blind or permanently and totally disabled;

• a brother or sister who has an equity interest in the home and who has lived in the home for at least one year prior to the date you enter the nursing home; or

• a son or daughter or grandchild who lived in your home for at least two years immediately before you entered the nursing home and who provided care to you which allowed you to live in your home instead of in a nursing home.

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