South Carolina Medicaid Asset Test

What Do I Need For Proof Of Income

In order to prove that you fall within the limit for income eligibility, you will need to provide documentation of all sources of income that you have.

Documents to include are things like pay stubs from wages, copies of social security deposits, copies of alimony checks, and award letters from any other monthly financial benefit that you may receive.

It would also be helpful to have all of your most recent income tax returns and any other tax forms that would be relevant to verifying your income.

Some states are able to electronically gather the resources to verify your income, which does simplify the process as well as eliminate fraud. To find out if your state has this technology for your application, click here to learn more about the application process in your state of residence.

Applying For South Carolina Medicaid Long Term Care Programs

The first step in applying for Healthy Connections Long Term Care coverage is deciding which of the three Medicaid programs discussed above you or your loved one wants to apply for Nursing Home Medicaid, Home and Community Based Service Waivers or Aged Blind and Disabled Medicaid / Regular Medicaid.

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 Healthy Connections when not financially eligible will result in the application, and benefits, being denied.

During the process of determining financial eligibility, its important to start gathering documentation that clearly details the financial situation for the Healthy Connections applicant. These documents will be needed for the official Medicaid application. Necessary documents include five years of quarterly bank statements from all accounts the most recent monthly or quarterly statements from all investments, IRAs, 401Ks, annuities and any other financial accounts a letter from the Social Security Administration showing the applicants gross Social security income and deductions tax forms to verify income streams including wages, pensions, royalties and interest lists of items of any trusts proof life insurance and a list of beneficiaries Power of Attorney documentation.

Choosing a South Carolina Medicaid Nursing Home

Aged Blind Disabled Medicaid Pathway

The aged, blind, and disabled pathway to Medicaid eligibility is the most common pathway to eligibilityfor those with a disability or over 65 years old. In general, states count your household sizeas one or two, depending on whether you are married.While there is an income limit and asset limitfor ABD Medicaid, there are significant deductions to your income that may apply, includingignoring half of your earned income. For a more accurate estimate use our Medicaid eligibility calculator.

ABD Income Limits

$11,340 in assets

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What Is Nc Medicaid/health Choice Outreach

NC Medicaid and Health Choice are publicly funded children’s health insurance programs open to North Carolina residents who meet income, age, and immigration guidelines. Your child may qualify for healthcare coverage through Medicaid or Health Choice, NCâs CHIP program — both offer free or low-cost health insurance for children and teens. For more information on wellness visits, and treatment services, click here.

To meet outreach goals, our staff work with community and faith-based organizations across the State to:

• Partner with local family-centered activities: health fairs, school sports/events, community-ethnic festivals.
• Distribute materials to families by ordering available materials at no cost or downloading copies of PDFs provided.
• Partner with local minority media outlets to extend the reach of critical enrollment and reenrollment messages as needed.

What Are The Medicaid Asset Limits In 2022

If you are looking into applying to receive Medicaid, whether it is for the first or hundredth time, your eligibility is decided based on your income. However the income eligibility can change from year to year, depending on the economy and what sort of care you require.

The Medicaid Income Eligibility chart is a tool for determining if your income falls under the limit, depending on if you need regular medicaid or Medicaid for long-term nursing care. All you need to do is find the listings for your state, line that up with the care you need, and then you will see the income limit for both single and married applicants.

If you are looking for an overview of the Medicaid Income Eligibility Chart regarding your situation, this is the article you need to read. Here, I will be providing all of the information for each state, type of care, and marital status for those who are trying to learn the facts. Read on to get more information about the benefits that are available to you!

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Premium Tax Credit Income Limits

The Premium Tax Credit is a tax credit on health insurance plans purchased through the HealthInsurance Marketplace. Households can take this tax credit in advance,using it to lower the monthly premium on their health insurance plan.Credit amounts are based on household income and are available to households with incomeabove 100% of the Federal Poverty Level. Therefore, the income limits below are the minimumincome limits: only households with more than the monthly amount are eligible.Typically, the credits phase out above 400% of the Federal Poverty Level , however for 2022 marketplace planscredits may be offered for households with higher incomes. If you are eligible for health insurancethrough your employer, in most cases you are not eligible for the Premium Tax Credit.One exception to the 100% Federal Poverty Level minimum income requirement for the Premium Tax Credit appliesif an individual is a lawfully presentimmigrant who would be eligible for Medicaid if it weren’t for their immigration status.For these individuals, the Premium Tax Credit becomes available even if the household has $0 in income.

• 1 person household
• Each additional person in household+$393 / month

Nc Medicaid Nursing Home Rules: Liens And Estate Recovery

The state has the right to recover whatever benefits it paid for the care of the Medicaid recipient from his or her probate estate. Given the rules for Medicaid eligibility, the only property of substantial value that a Medicaid recipient is likely to own at death is his or her home. Under current law, the state may make a claim against the decedents home only if it is in his or her probate estate.

Property that is jointly owned with rights of survivorship, in a life estate, or in a trust, is not included in the probate estate and thus escapes estate recovery. Congress has given the states the right to seek estate recovery against such nonprobate property so far, North Carolina has not acted on this provision.

Contrary to popular belief, there is no such a thing as a Medicaid or nursing home lien in North Carolina. Upon the death of a Medicaid recipient, and providing no exception to to estate recovery applies , DHB is a fifth class creditor against the probate estate of the deceased recipient DHB gets in line with other creditors of equal rank.

The law also provides exceptions to estate recovery when hardship can be proven. In other cases DHB will completely forego estate recovery if the deceased is survived by a spouse or a minor or disabled child. You should always seek assistance from qualified counsel if facing estate recovery.

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South Carolina Medicaid Asset Limits 2019

Individuals in South Carolina are allowed to keep $2,000 when they apply to Medicaid for long term care. If they are over this amount, they must spend down on care. It is important to note, that individuals are not allowed to give gifts of any amount for a period of 5 years prior to applying to Medicaid. If an individual’s assets are more than $2,000, they should learn about Medicaid Planning strategies. This asset limit only applies to assets that are considered countable assets. Some examples of countable assets include savings accounts, bank accounts, retirement accounts and a second home. If you have multiple assets and are looking to access Medicaid, it may make sense to speak with a Medicaid Planner or Elder Law attorney in South Carolina.

Couples that both require Medicaid for long term care in South Carolina are allowed to keep $2,000 in assets. If there is one spouse that requires care, and one that does not, the spouse that does not receive care is referred to as the Community Spouse. The Community spouse is allowed to keep up to $123,600 in countable assets which is known as the Community Spouse Resource Allowance.

The maximum amount of home equity allowed when applying to Medicaid is $572,000. Despite the fact the home is not a countable asset, Medicaid, can look for repayment in probate court from the proceeds of a sale after it stops paying for care. It is important to understand if your home may be subject to the Medicaid repayment process.

Nc Medicaid Nursing Home Rules: Treatment Of Assets For A Married Couple

Medicaid provides special protections for the spouse of a nursing home resident, known in the law as the community spouse. Under the general rule, the spouse of a married applicant is permitted to keep one-half of the couples combined countable assets up to $137,400 . In addition, there is a minimum resource allowance for the community spouse of $27,480 . The protected amount is referred to as a Community Spouse Resource Allowance or CSRA.

The CSRA is calculated with respect to assets held by a married couple as of the beginning of the first continuous 30 consecutive day period that the applicant spouse has been confined to a hospital or nursing home or some combination of the two. For the sake of administrative convenience, DHB will actually measure the assets as of the close of the last business day of the preceding month. This is sometimes referred to as a snapshot date. It does not matter when the Snapshot Date occurred. It is not at all uncommon to have a Snapshot Date that was triggered several years before the date of a Medicaid application.

Often, it is advantageous for the couple to try to have as much money as possible in their names on the Snapshot Date up to $274,800 so that the amount the community spouse is allowed to keep will be as high as possible. Sadly, many couples believe they understand the rules and spend half of their assets before a Snapshot Date only to later discover they must reduce their assets by half again!

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Nc Medicaid Nursing Home Rules: Treatment Of Income

The income eligibility rules are convoluted, but in summary, if the applicants income is in excess of the facilitys private pay rate, the applicant will not be eligible for Medicaid.

When a nursing home resident becomes eligible for Medicaid, all of his or her income, less certain deductions, must be paid to the nursing home. The deductions include a $30-a-month personal needs allowance, a deduction for any uncovered medical costs , and, in the case of a married applicant, an allowance he or she must pay to the spouse that continues to live at home.

As will be discussed a bit more below, Medicaid considers only the income of the applicant and not that of the community spouse . Medicaid uses a name on the check rule in determining income.

Spousal Income

In all circumstances, the income of the community spouse will continue undisturbed he or she will not have to use his or her income to support the nursing home spouse receiving Medicaid benefits.

In some cases, the community spouse is also entitled to share in all or a portion of the monthly income of the nursing home spouse. DHB determines an income floor for the community spouse, known as the minimum monthly maintenance needs allowance, or MMMNA. If the community spouses own income falls below his or her MMMNA, the shortfall can be made up from the nursing home spouses income. The NC MMMNA is $2,178 .

South Carolina Medicaid / Healthy Connections Long Term Care Programs Benefits & Eligibility

SummaryMedicaid is a joint federal and state program, so its rules, coverage plans and even its name all vary by state. This article focuses on South Carolina Medicaid Long Term Care, which is different from regular Medicaid. In South Carolina, Medicaid is called Healthy Connections. South Carolina residents can receive long-term care benefits through Medicaid in a nursing home, in their home and in other residential settings through one of three programs Nursing Home / Institutional Medicaid, Home and Community Based Service Waivers or Aged Blind and Disabled Medicaid.

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Calculating The Spend Down Amount

While one may know its necessary to spend-down some of their countable assets to qualify for Medicaid, the exact amount that needs to be spent down may be unclear. This is because the asset limit varies by state, as well as if one is single or married, and if married, if one or both spouses are applying for Medicaid. While the preceding factors are relatively simple to calculate, states also vary in the way they calculate the amount of countable assets a healthy spouse can keep. This adds to the complexity of the calculation.

IndividualsThe asset limit for a single elderly individual for long-term care is $2,000 in most states. However, there are some exceptions. For example, as of 2022, the asset limit for a single individual in Connecticut is $1,600, in Nebraska it is $4,000, and in Minnesota it is $3,000.

When a couple is married, all assets are considered joint assets. Learn more about joint assets here. In most states, the asset limit for a couple where both spouses are applying for Medicaid is $3,000. Again, there are exceptions to this rule. For instance, in 2022, the asset limit in this situation for long-term care is $4,000 in Arizona, $6,000 in North Dakota, and $24,600 in New York.

Income Limits In South Carolina For Medicaid

In South Carolina the individual receiving Medicaid cannot have income over $2,250. If their income is over that amount, they will need to do some Medicaid Planning to create eligibility. One strategy that works well is a Miller Trust . If an individual is married, the spouse’s income does not typically count towards the income cap, but it is important to maximize income protection via the Monthly Needs Allowance rules. The maximum amount of income the Medicaid office allows a community spouse to keep in South Carolina is $3,090. All of an individual’s monthly income must go towards their cost of care, which can include medical bills, prescriptions and other health care costs, aside from $30 which is for a personal needs allowance. The income limits are based as a percentage of the Supplemental Security Income defined by the Social Security Administration’s Federal Poverty Levels and change every year.

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What Are The Different Types Of Care Available

Regular Medicaid is the health care benefits program available to all of a states residents, providing they meet the eligibility requirements. Some of the eligibility requirements include:

• Legal status on the United States
• Resident of the state of application

Those who meet these criteria are able to use their regular Medicaid benefits for their doctors visits, hospital care, laboratory testing, and transportation for medical purposes.

The income limit for regular medicaid will be a set amount, depending on state and marital status. Some states allow one lump sum for a married couple and others have an income limit per spouse.

Medicaid for long-term nursing home care is for those who are elderly and can no longer live independently, those with chronic illness, and people with disabilities. At the facility, the residents receive 24/7 supervision and medical care, as well as lodgings and meals.

All state residents who meet the eligibility criteria and require long-term nursing home care are entitled to and will receive the care. There are no waitlists or lotteries for this benefit and you cant be denied if you meet the eligibility requirements.

However, that is not the case with Medicaids home-based nursing care. This care is for seniors who require daily medical assistance but have enough independance to and prefer to age in their own homes.

How Eligiblity Is Determined

Eligibility for Medicaid for adults aged 19 to 64 requires meeting an income limitthat is based on your household size.There is no asset test.

Your household size for Medicaid is typically the same as your tax filing household size:you + your spouse + your dependents. If you’re claimed as a dependent by someone else, or if yourpregnant, your household size may vary from your tax household size. If either of thosesituations apply to you,try using our Medicaid Eligibility Calculator for assistance calculating yourhousehold size.

A household’s Modified Adjusted Gross Income is used for eligibility decisionsfor many medical assistance programs. It’s similar to Adjusted Gross Income which is on your tax return, however some uncommon deductions are added back.For most people it shouldn’t be too much different than your total household income, so when readingthe charts below use the combined income from all household members from jobs and other sources,except for child support, Supplemental Security Income, and childrens’ non-taxable income.

Some pathways for Medicaid eligibilty may only be available if you’re a parent to a child 18 or youngeror are pregnant or were pregnant in the last 12 months.

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Nc Medicaid Nursing Home Rules: The Asset Rules

The basic rule of nursing home Medicaid eligibility is that an applicant, whether single or married, may have no more than $2,000 in countable assets in his or her name. In other words, when someone applies for Medicaid a very careful inventory of all that persons assets is taken. The assets are divided into two types: Countable and Noncountable.

If the applicant is married, the spouse is called the Community Spouse, and there are rules concerning how many countable assets the Community Spouse may keep. Those rules will be discussed further below.

Countable assets generally include all belongings except for personal possessions, such as clothing, furniture, and jewelry, one motor vehicle, the applicants principal residence, and assets that are considered inaccessible for one reason or another. The asset rules are quite complex. This article will attempt to untangle the major rules.

Keep in mind, the rules discussed in this part relate to qualifying for Medicaid and have nothing to do with transferring those assets or whether those assets might be subject to estate recovery upon the death of the applicant. Those rules will be discussed in detail below.

Real Property: The Home

A home with equity of less than $636,000 will not be considered a countable asset and, therefore, will not be counted against the asset limits for Medicaid eligibility purposes as long as the nursing home resident intends to return home or his or her spouse or other dependent relatives live there.