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Professional Medicaid planners are educated in the planning strategies available in the state of Michigan to meet Medicaid’s financial eligibility criteria without jeopardizing Medicaid eligibility. Furthermore, there are additional planning strategies that not only help one meet Medicaid’s financial criteria but can also protect assets for family as inheritance. While these strategies protect assets from Medicaid’s estate recovery program, they often violate Medicaid’s 60-month look back rule.
If none of the above-mentioned people live in the home, the home can be exempt if the applicant/beneficiary files an “intent to return” home and the home equity interest is at or below $636,000. For married applicants, the 2022 asset limit for Michigan ABD Medicaid is $3,000 combined between the two applicants/spouses, and the income limit is a combined $1,526 / month. These limits are used for both married couples with both spouses applying for ABD Medicaid and married couples with only one spouse applying. This is determined through a state assessment and reports from the applicant’s doctors and other relevant healthcare professionals.
Application Process:
While both income and assets are considered for Medicaid eligibility purposes, the limits vary based on the state in which one resides and the program for which one is applying. To be eligible for the regular state Medicaid program, one must meet the criteria set forth for their specific eligibility group. For the purposes of this article, the eligibility group is “aged, blind and disabled”.
One’s home is often their most valuable asset, and if counted toward Michigan’s Medicaid asset limit, it would likely cause them to be over the limit for eligibility. However, in some situations the home is not counted against the asset limit. If the applicant lives in their home and the home equity interest is less than $636,000 , then the home is exempt from the asset limit. Home equity interest is portion of the home’s equity value that the applicant owns, and the home’s equity value is the current value of the home minus any outstanding mortgage / debt against the home. If the applicant’s spouse, minor child, or blind or disabled child of any age lives there, the home is exempt regardless of the applicant’s home equity interest, and regardless of where the applicant lives.
Maternity care
For long-term care services via the Regular Medicaid program, a functional need with the activities of daily living is required, but a NFLOC is not necessarily required. When only one spouse of a married couple applies for home and community based services via a Medicaid Waiver or for Medicaid nursing home care, only the income of the applicant is counted. This means the income of the non-applicant spouse is disregarded and does not impact the income eligibility of their spouse. The non-applicant spouse, however, may be entitled to a Minimum Monthly Maintenance Needs Allowance from their applicant spouse. The MMMNA is a spousal impoverishment rule and is the minimum amount of monthly income a non-applicant spouse is said to require to avoid spousal impoverishment. 2) Medicaid Waivers / Home and Community Based Services – These are not entitlement programs; There are a limited number of participants and wait lists may exist.
It includes benefits such as adult day care, home modifications to enable aging in place, respite care, independent living skills training, and many other supports. Non-Financial Eligibility Requirements – For Michigan Medicaid long term care, an applicant’s functional need is considered. For nursing home Medicaid and Medicaid Waivers, a nursing facility level of care is required. Furthermore, some program benefits may require additional criteria be met. For instance, for home modifications, an inability to live independently without the modifications may be necessary.
Reasons to choose Priority Health
In most cases, it takes between 45 and 90 days for the Medicaid agency to review and approve or deny one’s application. Based on law, Medicaid offices have up to 45 days to complete this process . However, despite the law, applications are sometimes delayed even further. For people that need to join a health plan, Michigan Enrolls will send a letter with more information. After enrollment with a health plan, both the mihealth card and the health plan card are needed to access services.
Unfortunately, Michigan is one of only a few states that does not allow irrevocable funeral trusts . IFTs are pre-paid funeral and burial expense trusts that Medicaid does not count as assets. With this type of contract, funeral and burial goods / services are pre-selected and paid in advance.
Health Home Providers
In Michigan, Medicaid is sometimes called Medical Assistance. Home and Community Based Services through Medicaid waivers are not entitlement programs. Therefore, meeting the eligibility requirements does not equate to automatic receipt of benefits. It’s important that one does not give away assets or sell them under fair market value within 60 months of applying for long term care Medicaid.
That includes working adults, people with disabilities, pregnant women, and children. If that’s you, check out UnitedHealthcare Community Plan Medicaid. This table does not include notations of states that have elected to provide CHIP coverage of unborn children from conception to birth. The second step is determining if the applicant meets the financial and functional criteria, also discussed above, for that Long Term Care program. Applying for Michigan Medicaid when not financially eligible will result in the application, and benefits, being denied.
It often allows care recipients to hire relatives as paid caregivers. Commonly, adult children can be hired and paid to provide care for their aging parents. 4) Program of All-Inclusive Care for the Elderly – The benefits of Medicaid, including long-term care services, and Medicare are combined into one program. Additional benefits, such as dental and eye care, may be available.
To be eligible for Michigan Medicaid, a person has to meet certain financial requirements and functional requirements. In order to be eligible for this program, applicants must need hands-on assistance with at least one Activity of Daily Living. Michigan uses an Adult Services Comprehensive Assessment (MDHHS-5534) to make this determination.
MI Health Link delivers its benefits through a single Medicaid plan provided by an Integrated Care Organization that has its own network of care providers. Program participants receive all of their medical care (doctor’s visits, lab work, prescription medication, hospitalization, nursing home care, etc.) through this plan. And the plan will provide all of the in-home services for individuals who are also eligible for the MI Health Link HCBS Waiver. These benefits include adult day care, home modifications, medical equipment, nursing services, transportation and personal care help with the Activities of Daily Living . Some of these benefits, like the personal care help, can be self-directed, which means the program participant can select their own caregiver. This includes adult children, adult grandchildren, nieces, nephews and siblings, but not spouses.
Like all HCBS Waivers, the MI Health Link HCBS Waiver is not an entitlement. This means that even if an applicant is eligible, they are not guaranteed to receive the benefits. Instead, there are a limited number of enrollment spots and once those spots are full any additional eligible applicants will be placed on a waiting list. Currently, the MI Health Link HCBS Waiver is approved for a maximum of 5,100 program participants per year. Like all HCBS Waivers, the MI Choice Waiver Program is not an entitlement.
Seniors can order replacement MIhealth cards via the helpline or website. In Michigan, in-home care is approximately $3,566 per month cheaper than nursing care, with average costs of $5,529 and $9,095 respectively. At around $4,250 per month, assisted living is a little more affordable, although seniors can’t remain in their own homes. As in most states, adult day health care is the least expensive long-term care option, with an average monthly cost of $1,733. For married applicants with both spouses applying, the 2022 asset limit for HCBS Waivers in Michigan is $3,000 combined, and the income limit is $2,523 / month per spouse.
This may include the home of a friend or relative, an adult foster care home, or an assisted living residence. The exact settings in which one can receive services depends on the state and the Medicaid program. 2) MI Health Link – A managed care program for persons who are dually eligible for Medicaid and Medicare, a variety of supportive services are available to promote independent living. Benefits may include personal care assistance, meal delivery, chore services, and personal emergency response systems. MDHHS is responsible for approving Home Help providers for participation in the program.
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