See If You Qualify For The Healthy Michigan Plan
The Healthy Michigan Plan provides health care benefits to Michigan residents at a low cost so that more people can have health care coverage. Individuals are eligible for the Healthy Michigan Plan if they:
- Are age 19-64 years
- Have income at or below 133% of the federal poverty level*
- Do not qualify for or are not enrolled in Medicare
- Do not qualify for or are not enrolled in other Medicaid programs
- Are not pregnant at the time of application
- Are residents of the State of Michigan
*Eligibility for the Healthy Michigan Plan is determined through the Modified Adjusted Gross Income methodology.
Medicaid And Medicare Dual Eligibility
If you qualify for both Medicare and Medicaid, you are considered dual eligible. In this case, you may qualify for a certain type of Medicare Advantage plan called a Dual Eligible Special Needs Plan . D-SNPs are designed to meet the specific needs of people who have Medicaid and Medicare.
You can compare plans online to find out if D-SNPs are available where you live, or you can call to speak with a licensed insurance agent for information about eligibility and enrollment.
Social Security Beneficiaries Just Got Their Biggest Raise In More Than Four Decades
Inflation hit the U.S. economy hard over the past year, but few Americans felt the impact more sharply than the nation’s 65 million Social Security beneficiaries. The rising price of gas, groceries, utilities, and medical care made life difficult for those individuals, eating away at the purchasing power of their Social Security benefits. That’s especially true because the 5.9% cost-of-living adjustment applied to benefits in 2022 dramatically underestimated the impact of inflation.
Fortunately, beneficiaries have received some much-needed good news this month. The Centers for Medicare and Medicaid Services recently announced that the standard Medicare Part B premium will drop 3% to $164.90 per month next year. Additionally, the September inflation report from the Bureau of Labor Statistics — which was released earlier today — suggests life might get a little easier next year.
Image source: Getty Images.
First, the year-over-year change in the Consumer Price Index for Urban Wage Earners and Clerical Workers decelerated to 8.5% in September, down from 8.7% in August, meaning inflation continued to cool last month. Second, the September CPI-W was the last piece of information needed to calculate the Social Security COLA for 2023. The finalized cost-of-living adjustment figure is 8.7%. That is the largest COLA since 1981.
Here’s what you need to know.
Don’t Miss: Apply For Medicaid For My Child
Who Is Eligible For Medicaid In California
To receive Medi-Cal benefits in California, you must be a U.S. citizen, a state resident of California, a permanent U.S. resident, a legal alien or a U.S. national. You are eligible to receive benefits if you are:
- Over the age of 65
- Blind or disabled
- In a nursing or intermediate care home
- Under the age of 21
- A refugee living in the U.S. temporarily
As a parent or guardian relative of a child who is under the age of 21, you may be eligible for Medicaid assistance if youre taking care of the child because the parents:
- Do not live with the child
- Are incapacitated
- Are not employed
You may also qualify for Medi-Cal benefits if you are already enrolled and receiving benefits from one or more of the following programs:
- CalFresh also known as the Supplemental Nutrition Assistance Program
- Supplemental Security Income / State Supplementary Payment
- CalWorks also known as Temporary Assistance to Needy Families
- Refugee Assistance
- Foster Care or Adoption Assistance Program
How Does The Medicaid Caregiver Program Work
As a caregiver, you may understandably need assistance with not only caregiving tasks but also the financial burden of providing that care. Unfortunately, there is no uniform national standard or help for caregivers. Most programs require that you meet financial and or needs-based criteria.
Jump ahead to these sections:
Family caregivers provide most of the care of someone older or disabled in the US. The reason for this is that paying for care can be expensive and deplete the financial estate of the caregiver and receiver. There are wealthy caregivers to pay for care, care recipients who have a low enough income and asset level to qualify for Medicaid, and then everyone else who is left to figure out how to pay for care.
As arduous and complicated as applying for Medicaid caregiver programs can be, it is worth doing so because it can make a significant difference. We will walk you through the different programs that might be available to you in your state.
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Newly Eligible Missourians Can Now Apply For Medicaid
Newly eligible Missourians can now apply for Medicaid health benefits by applying online, or by phone 373-9994.
Adults under the age of 65 with household incomes up to 138% of the federal poverty level are now eligible for Missouri Medicaid. In 2021, this amounts to about $17,774 for an individual or $24,039 for a household of two. Unsure if youre eligible? Use the Medicaid Eligibility Calculator to find out.
The Missouri Department of Social Services began processing newly eligible adult applications on October 1, 2021.
Pregnant women and children were already eligible for Medicaid or CHIP at higher income levels. In addition, low-income residents who are blind or have disabilities are also eligible but must meet strict asset limits to qualify. Please visit the MO HealthNet website for more eligibility information.
Medicaid For Children And Adults
Eligibility for Medicaid and Dr. Dynasaur are based on the current year Federal Poverty Level guidelines.
- The monthly income limit for adults ages 19 through 64, who are not blind or disabled, is 138% FPL.
- The monthly income limit for children under age 19 is 317% FPL. . There is a monthly premium for some households based on your income. For families up to 195% FPL, there is no premium. There are no prescription co-payments.
- The monthly income limit for Vermonters who are pregnant is 213% FPL. Dr. Dynasaur for pregnant women provides the same coverage as Medicaid, plus full dental coverage. There are no premium or prescription co-pays with this type of Dr. Dynasaur.
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How Lengthy Does Medicaid Final
How Long Will My Medicaid Benefits Last? Your advantages will final so long as you stay eligible. If you get a brand new job or transfer to a special state, you have to report it often inside 10 days. Talk with a consultant on the Medicaid workplace about how these modifications will have an effect on your protection.
Medicaid Eligibility By State
Each state in the US has different eligibility requirements. Senior Planning offers an interactive map showing Eligibility for Medicaid long-term care. Just pick the state you want to see the requirements for.
Medicaid is available for low-income people and families. For people who dont qualify for Medicaid, open enrollment starts in November 2022. Visit Get Covered Illinois to learn more about healthcare coverage options. If you have not registered yet, you may qualify for Marketplace through the Special Enrollment Period. You have 60 days after a qualifying event to enroll.
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Work Requirements And Medicaid In 2018 And Beyond
In April 2021 President Joseph Biden began unwinding the previous administrations attempts to create and implement new eligibility requirements for adults without children or disabilities. These requirements would have allowed states to remove Medicaid coverage from childless adults who are not disabled, who do not have jobs, or are not involved in work-related or volunteer programs. Even states that received approval had not enforced work requirements as of April 2021, because federal courts invalidated the rules.
In an effort to encourage states to expand Medicaid, President Bidens 2021 American Rescue Plan contains more matching of federal funds as an incentive. The U.S. Department of Health and Human Services has now revoked work requirements in the Medicaid programs of Arizona, Arkansas, Indiana, Michigan, New Hampshire, Ohio, South Carolina, Utah and Wisconsin. Kentucky and Nebraska withdrew their applications for work requirements after initially receiving approval.
According to the Pew Charitable Trusts, at least 15 states either applied for or received permission to impose work requirements during the previous administration. The nonpartisan research and policy Center on Budget and Policy Priorities reported that in 2018, Arkansas removed more than 18,000 Medicaid beneficiaries off the rolls because they did not meet new eligibility requirements.
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Medicaid Facilitates Access To Care
A large body of research shows that Medicaid beneficiaries have far better access to care than the uninsured and are less likely to postpone or go without needed care due to cost. Moreover, rates of access to care and satisfaction with care among Medicaid enrollees are comparable to rates for people with private insurance . Medicaid coverage of low-income pregnant women and children has contributed to dramatic in the U.S. A growing body of research indicates that Medicaid eligibility during childhood is associated with reduced teen mortality, improved long-run educational attainment, reduced disability, and lower rates of hospitalization and emergency department visits in later life. Benefits also include second-order fiscal effects such as increased tax collections due to higher earnings in adulthood. Research findings show that state Medicaid expansions to adults are associated with increased access to care, improved self-reported health, and reduced mortality among adults.
Figure 7: Nationally, Medicaid is comparable to private insurance for access to care the uninsured fare far less well.
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Medicaid Spend Down: How To Qualify For Medicaid If You Make Too Much Money
The Medicaid Spend Down is an often overlooked way to qualify for Medicaid when you make too much money and dont otherwise qualify.
The reason you might want to do a Medicaid Spend Down is if you are needing medical care services like long-term nursing care or a home caregiver the Medicaid program will pay for some of these costs.
In this article, I will explain the basics of the Medicaid Spend Down and tell you about a special type of lawyer who can help you to through this process so that you qualify for Medicaid.
Lets first start with what is the Medicaid Spend Down.
What Benefits Are Covered Under Medicaid In California
When you go without health insurance, any cough, cold or injury can be a cause for concern. You might worry about how youll pay for health care when you need it. Fortunately, Medi-Cal takes the worry out of affording health coverage. The program provides coverage for preventative medical care and treatment when youre sick or injured.
The Affordable Care Act requires qualified health plans, including Medicaid plans, to offer coverage of Essential Health Benefits, which include:
- Physical and occupational therapy
- Preventive and wellness services and chronic disease management
- Dental and vision care
If youve been putting off seeing a doctor or getting a treatment you need out of concern about its cost, getting coverage from Medi-Cal can help you take care of your health.
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Medicaid Eligibility Income Chart By State Updated Jul 2022
The table below shows Medicaids monthly income limits by state for seniors. Income is not the only eligibility factor for Medicaid long term care there is also an asset limit and level of care requirements. Additionally, there are state-specific details. Click on the state name below to see that states complete Medicaid eligibility criteria.
The maximum income limits change dependent on the marital status of the applicant, whether a spouse is also applying for Medicaid, and the type of Medicaid for which they are applying. Nursing home Medicaid may have a different income limit than home and community based Medicaid services, and both of those may differ from the Aged, Blind and Disabled income limits.
Exceeding the income limits does not mean an individual cannot qualify for Medicaid. Most states have multiple pathways to Medicaid eligibility, such as a medically needy pathway. Furthermore, many states allow the use of Miller Trusts or Qualified Income Trusts to help person who cannot afford their care costs to become Medicaid eligible. There are also Medicaid planning professionals that employ other complicated techniques to help persons become eligible. Finally, candidates can take advantage of spousal protection laws that allow income to be allocated to a non-applicant spouse.
| Medicaid Eligibility Income Chart Updated July 2022 |
| State |
Why Would You Want To Qualify For Medicaid
The main reason that senior citizens seek help qualifying for Medicaid is to receive help paying for medical services. Many times people need help paying for either a long-term nursing home or a home caregiver.
While Medicare will pay for a short-term stay in a skilled nursing facility to help you recover, it will not pay for a long-term nursing home. If you also had Medicaid, this would pay for the cost of a nursing home.
Editors note: Medicare is federal health insurance for senior citizens and those with disabilities. Medicaid on the other hand is state health insurance for people with low incomes. It is possible to qualify for both if you are a low-income AND a senior/person with a disability.
The same is true for a home caregiver. If you only have Medicare, this will not pay for a home caregiver. Medicaid on the other hand will pay for these services.
Essentially if you are a senior with only Medicare your coverage will not pay for a nursing home or a home caregiver. You need to find a way to qualify for Medicaid because this insurance will cover these medical services. The Medicaid Spend Down strategy helps you to qualify.
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People Who Have Both Medicare & Medicaid
People who have both Medicare and full Medicaid coverage are dually eligible. Medicare pays first when youre a dual eligible and you get Medicare-covered services. Medicaid pays last, after Medicare and any other health insurance you have.
You can still pick how you want to get your Medicare coverage: Original Medicare or Medicare Advantage . Check your Medicare coverage options.
If you choose to join a Medicare Advantage Plan, there are special plans for dual eligibles that make it easier for you to get the services you need, include Medicare coverage , and may also cost less, like:
- Special Needs Plans
- Medicare-Medicaid Plans
- Program of All-Inclusive Care for the Elderly plans can help certain people get care outside of a nursing home
Family Caregiver Pay Rate And Salary In 2022
Homecare Planning Solutions is a division of Edison Home Health Care dedicated to helping consumers navigate todays often complex home care system.
Please Note: Edison Home Health Care is a Fiscal Intermediary for CDPAP. We do not administer the program. We can help you navigate, but application and enrollment for CDPAP must go through your Local Department of Social Services or Medicaid plan.
If youre looking to hire a family caregiver under CDPAP, you are probably curious what the hourly pay rate is and what your family caregivers yearly salary will be. The pay rate for CDPAP caregivers can vary based on a number of factors, so it is difficult to publish a specific rate. Still, we can say that as a general rule our pay rates range between $13.20 $19.09 per hour and $19.80 $28.63 per overtime hour. These rates do not necessarily indicate the highest paying rates at our Fiscal Intermediary. Additionally, some consumers often receive different amounts of hours than other consumers, which can impact a caregivers yearly salary.
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Taking Advantage Of Magi
The Affordable Care Act simplified Medicare eligibility and enrollment for millions of Americans. Using MAGI for eligibility simplified the application process. The administrative burden of confirming assets was put to the wayside. Unfortunately, it also gave wealthy people the opportunity to take advantage of taxpayer dollars.
This loophole occurs because the majority of Americans now qualify for Medicaid through MAGI, which unless you are seeking long-term nursing home care no longer uses the asset test. People who are asset rich, particularly those who have investments or real estate properties, can still technically meet MAGI criteria.
Someone could own a home worth $850,000, a Lamborghini, a second vehicle, hundreds of acres of farmland, and still technically be eligible for Medicaid.
These Americans would be considered wealthy by any standards but by sheltering their net worth under the current tax laws, they would be legally eligible for Medicaid or subsidized plans through the Health Insurance Marketplace. This is the case even when they could easily dip into their assets to pay for health insurance.
If the intent is to provide health care to the most financially needy, MAGI Medicaid may need to consider how it addresses this loophole. The GOP is currently looking to repeal Obamacare which would, in effect, put an end to MAGI Medicaid altogether.
When And Why Was The Federal Poverty Level Established
The federal poverty thresholds were first introduced in 1965, based on the work of the Social Security Administrations Mollie Orshansky. The amounts were tied to the bare minimum amount that people needed in order to have adequate food, with a multiplier used to account for other necessary expenses. Orshansky noted at the time that the poverty thresholds were a measure of the amount of income that would be inadequate for people to live, as opposed to a minimum adequate amount.
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