To receive Medicaid, your income must also fall below certain levels set by your state of residence.
The government considers all income – regardless of the source – as available for spending on care, but excludes the following:
- Personal monthly needs allowance: A set amount each month used to cover expenses such as food, housing and transportation
- Medicare Part B and Medicare Supplemental Insurance Premiums (if you are eligible)
- Other small deductions permitted by a state’s specific parameters
Marriage and Medicaid
For married couples where only one spouse is receiving care, the Medicaid financial means test could leave the independent spouse with little to no income or resources.
To help ensure that the spouse who remains in the community is able to live independently and with dignity, Congress enacted a provision called the Spousal Impoverishment Act. This act protects a certain amount of the couple's combined resources for the spouse living independently.
To qualify, the spouse living independently must meet several conditions:
- They must be legally married to the spouse receiving care.
- The spouse receiving care must reside in a medical institution or nursing facility and be likely to remain there for at least 30 consecutive days.
- They cannot also be receiving long-term care in a medical institution or nursing facility.
What Medicaid covers
Medicaid provides a broad level of health insurance coverage, including doctor visits, hospital expenses, nursing home care, home health care, and many other medical expenses and forms of care.3 Medicaid also covers long-term care costs, both in a nursing home and, by exception and in limited cases, at-home care.
Veterans Affairs benefits
The U.S. Department of Veterans Affairs provides benefits to previously active members of the U.S. military. Today’s veterans have a comprehensive medical benefits package, which the VA administers through an annual patient enrollment system.
What VA benefits cover
Benefits provided for custodial care are awarded through a priority system, with those assigned a higher priority category, such as someone injured through the act of war on active duty, receiving the first available care.
Those assigned lower priority categories may have access to custodial care depending on the availability of resources in their geographic location; however, it is not a guaranteed benefit, and individuals may be asked to cover their own expenses.
The VA’s Geriatrics and Extended Care program provides services for those who are elderly and have complex needs and veterans of any age who need daily support and assistance.
Veterans can receive care at home, at VA medical centers or in the community. If you are eligible to receive care, this program may pay for the following:
- Hospice services
- Medical foster homes
- Respite care
- State veterans homes
- Domiciliary (home) care
- Adult day health care