Medicaid is a needs-based program for people 65 years of age or older, or who are permanently blind or disabled. They must also meet certain income requirements and asset limits for their state. If someone receives Supplemental Security Income (SSI), then they are automatically eligible for Medicaid benefits and do not need to go through the application process.
- A U.S. citizen or show proof of eligible immigration status,
- Live in the state in which they are applying for benefits, and
- Have a social security number (or show proof of having applied for one).
There isn’t one set income limit for being able to use Medicaid for nursing home care in North Carolina. Rather than having an established income limit, Medicaid simply requires that all of your income be put towards your cost of care, outside of a few allowances.
The first allowance for any applicant is a $30 per month personal needs allowance. This personal needs allowance could be used for things like clothing, magazines, books, stationery, etc. Federal regulations require nursing homes to provide basic hygiene items like a toothbrush and toothpaste, so the personal needs allowance would not need to be used for those types of items.
Medicaid also allows every applicant an allowance for any uncovered medical costs, such as health insurance and Medicare supplement insurance premiums.
Spouse and Dependent Allowances
If an applicant is married, there are additional allowances that the applicant’s spouse may be able to receive.
- If the spouse’s income is less than the applicant’s, then the spouse can use some of the applicant’s income rather than requiring it to be contributed towards the applicant’s cost of care. This allowance is known as the Minimum Monthly Maintenance Needs Allowance (“MMMNA”).
- The current MMMNA in North Carolina is $2,178 per month, so if the applicant’s spouse makes less than $2,178 per month, the difference can be made up with the applicant’s income.
- The MMMNA can be increased up to $3,435 per month depending on the applicant’s circumstances. The increased allowance is for shelter costs, which can include rent or mortgage payment, taxes on the home, homeowner’s or renter’s insurance, required maintenance charges or homeowners’ association fees, or utility costs.
If an applicant is married with a dependent at home under the spouse’s care, then there is an additional income allowance the applicant can claim for the dependent. The current dependent income allowance for an applicant is $726 per month (or one-third of the base MMMNA).
If you are unsure if you or a loved one would currently qualify for Medicaid benefits and may need to apply soon, please give our office a call at 919-443-3035 or visit our website to schedule a free needs assessment call.