In 2020 Missouri voters approved a Medicaid expansion ballot measure and, finally, this new legislation is giving fruit—albeit slowly. The Medicaid expansion came into full effect in the state in October 2021 and yet by early 2022 only 58,000 people had enrolled. This number is well below the 190,000 projected giving rise to the question of why. Slow processing times play a part but so too do misunderstandings concerning Medicaid eligibility. This article aims to clear the air.
Medicaid Eligibility: What you Need to Know
Medicaid is a federal and state program that assists people with limited income cover healthcare costs. While often confused with Medicare, it is a distinct program offering distinct benefits. Most notably, Medicaid provides nursing home care and personal care services coverage that, for many, would be otherwise unaffordable. Despite being billed as a program for low-income individuals, Medicaid is widely accessible with proper planning. This is especially true in light of the recent expansion and thus it is crucial that individuals understand the nuances of how to qualify for Medicaid.
Medicaid in Missouri is called MO Health Net and the program is administered by The Missouri Department of Social Services.
Numerous Medicaid long-term care programs exist for which Missourians may be eligible; however, addressing each goes beyond the scope of this article. An estate planning attorney experienced in Medicaid planning is the best place to seek detailed information. That said, certain general criteria exist.
Under the new Medicaid expansion, anyone with a household income up to 138% of the poverty level may be eligible. In 2022, this means $18,754 for an individual and $38,295 for a household of four. In addition, to qualify for Medicaid, an individual must own limited assets. The specific dollar amount varies depending on the circumstances of an individual’s application but in most cases is capped at $5,035 in 2022. Cash, stocks, bonds, investments, savings, and checking accounts all count toward this number as does real estate not used as a primary residence. One’s home, personal belongings, furnishings, and vehicle are generally exempt.
While the approval of the Medicaid expansion is expected to expand Medicaid eligibility to an additional 275,000 Missouri residents, some readers may read the above numbers with dismay. Many people have assets and income that exceed the limits required of eligibility and yet this does not mean Medicaid coverage is out of reach.
Middle-income individuals can qualify for Medicaid with a little planning for the future but they must act fast. Strategic asset reallocation allows many people to meet the financial thresholds required of eligibility and yet Medicaid applies a five-year look-back period that means last-minute scrambling won’t work. Any asset transfers made in the five years prior to applying for the program will result in a penalty period which means failure to plan may result in failure to be able to afford needed care.