Nursing Home Coverage

If you or your spouse are entering a nursing home, you may qualify for Medicaid benefits, including paying a portion of your nursing home costs. To determine whether Medicaid can help right away, or after you have paid some nursing home bills yourself, you will need to carefully review your income, resources, and household circumstances.

Eligibility for Nursing Home Cost Assistance

Nursing home eligibility is based on your income and resources. The financial eligibility process takes several things into consideration.  Below are a few important items to understand about how income is counted and treated for Nursing Home eligibility: 

  • During the eligibility determination, DHW will determine how much income belongs to each spouse to find out if the spouse in the nursing home meets the income limit. In most cases, you must use the "name on the check" method. This is based on who receives each check or payment. If money is received in both names, half is counted for each spouse.
  • There is another method for dividing your income called "community property." It divides a couple’s total income in half and counts one-half for each spouse. Only one spouse can receive Medicaid when using this method.  
  • After you qualify for Medicaid, you may be able to use some of your income to support the spouse at home. This is separate from a resource transfer. 
  • If you decide to transfer income between spouses or to anyone else, you must follow certain rules or you could delay or lose Medicaid benefits. Make sure you contact the Department of Health and Welfare before you make any income transfers as it could impact your eligibility. 
  • Depending on your income, you may have a share of cost where you will be responsible to contribute to the cost of care. You will receive a notice from us regarding your share of cost. 
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Long Term Care Income Limits

Effective March 2020

   INCOME  RESOURCES
PROGRAM INDIVIDUAL  COUPLE INDIVIDUAL  COUPLE
Long-Term Facility Care $2,369 $4,718 $2,000  $2,000 (ea)**

 

**Couple resource limit will vary depending on living arrangement and FSI status 

EXTERNAL RESOURCES
If you have other questions about qualifying for Medicaid, contact the nursing home administrator or the Idaho Commission on Aging.
Contacts
Please contact Self-Reliance before taking action on any of this information as this is best explained by one of our specialists.
Address

PO Box 83720
Boise, ID 83720
United States