Medicaid

  1. Income limits:
  • APPLICANT’S GROSS INCOME LIMIT: $2,205 (or 3x full Supplemental Security Income/SSI benefit amount) (If over income, requires creation of Income Cap Trust (also called “Miller Trust” to qualify for Medicaid benefits.

State of Oregon only considers applicant’s income, not income of a spouse.)

(To determine gross income, add back in any deductions for Medicare Premiums, other health insurance and tax or other withholdings)

  1. Resource limits:
  • SINGLE PERSON’S NON-EXEMPT RESOURCE LIMIT: $2,000

(For a married couple both receiving Medicaid: $3,000)

For Married Persons (where one spouse receives Medicaid):

  • COMMUNITY SPOUSE’S* NON-EXEMPT RESOURCE LIMITS:

Floor/Minimum : $24,180; ceiling/maximum of $120,900. This means couple can keep 100% of nonexempt assets up to $23,844; over that amount divide assets by ½. Can keep ½ up to maximum of $120,900. Can not exceed $120,900/maximum unless you have court order or “community” spouse has low income.

Some examples:

Combined resources of $100,000 in nonexempt assets: one half of $100,000 = $50,000. And $50,000 is under maximum; therefore, can keep $50,000.

Combined resources of $200,000 in nonexempt assets: one half of $200,000 = $100,000. And $100,000 is under maximum; therefore, can keep $100,000.

Combined resources of $250,000 in nonexempt assets: one half of $250,000 = $125,000. And $125,000 is over maximum; can keep up to maximum $120,900.

Combined resources of $20,000 in nonexempt resources is less than minimum of $24,180 and therefore can keep $20,000.

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COMMON EXEMPT RESOURCES

Exempt assets are those assets that are not considered available to pay for care; hence they are not considered when evaluating whether one is eligible for Medicaid.

  • HOUSE (LIMIT: $500k equity value total/not per individual) when one of the following applies:

-applicant plans to return home

-adult child or children have lived in home for a period of 2 or more years and have during that time provided care to the Medicaid applicant.

-Medicaid applicant has a sibling with an equity interest in home

(sibling must live for at least one year in Medicaid applicant’s home)

-Medicaid applicant has a minor or disabled child.

-Medicaid applicant has a spouse living in the home.

  • CAR (UP TO $4,500)(or any value for vehicle used for medical transport)
  • PERSONAL POSSESSIONS and household items
  • MEDICAL EQUIPMENT
  • TERM LIFE INSURANCE POLICIES

One of the following is exempt:

  • INSURANCE

WHOLE LIFE: up to $1500 face value

  • BURIAL PLANS

“reasonable”

  • BURIAL FUND

$1500 in an account dedicated to this use.