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Nebraska Medicaid Eligibility for Long Term Care

Medicaid, known in Nebraska as the Nebraska Medical Assistance Program (NMAP), is a critical healthcare support system for low-income individuals, especially seniors. This guide aims to demystify the complex web of Medicaid’s long-term care options and eligibility requirements in Nebraska, providing a helpful resource for seniors and their families.

What is Medicaid in Nebraska?

Nebraska’s Medicaid program is designed to support various groups, but this guide focuses primarily on the elderly, specifically those 65 years and older. Managed by the Nebraska Department of Health & Human Services and funded by both state and federal governments, Medicaid offers a range of long-term care services, including:

  1. Institutional/Nursing Home Medicaid: A program ensuring assistance to all eligible seniors, primarily offered in nursing homes.
  2. Medicaid Waivers/Home and Community Based Services (HCBS): Aimed at delaying nursing home admissions, these limited availability programs offer services in more flexible settings like at home or in assisted living facilities.
  3. Regular Medicaid/Aged Blind and Disabled: This program provides long-term care benefits such as personal care and adult day care services.

Understanding the Financial Eligibility Criteria

One of the key aspects of Medicaid eligibility is the financial requirement, which varies annually and depends on the applicant’s marital status. For instance, a single senior applying for Nursing Home Medicaid in 2023 needs an income lower than $1,215 per month and assets below $4,000.

Detailed Income and Asset Limits for 2023

The following table provides a snapshot of the income and asset limits for different types of Medicaid programs in Nebraska:

Medicaid Program TypeSingle (Income Limit/Asset Limit)Married (Both Applying) (Income Limit/Asset Limit)Married (One Applying) (Income Limit/Asset Limit)
Institutional/Nursing Home Medicaid$1,215 / $4,000$1,643 / $8,000 (per spouse)$1,215 (applicant) / $4,000 (applicant) & $148,620 (non-applicant)
Medicaid Waivers/HCBS$1,215 / $4,000$1,643 / $8,000 (per spouse)$1,215 (applicant) / $4,000 (applicant) & $148,620 (non-applicant)
Regular Medicaid/Aged Blind and Disabled$1,215 / $4,000$1,643 / $6,000$1,643 / $6,000

Key Considerations for Income and Assets

  • Income Types: Almost all forms of income are counted towards Medicaid’s income limit, except for certain exceptions like Holocaust restitution payments.
  • Couple’s Income Treatment: If only one spouse applies for Institutional Medicaid or a Medicaid Waiver, only the applicant’s income is considered. However, for Regular Medicaid, both spouses’ incomes are combined.
  • Asset Categories: Medicaid considers assets like cash, stocks, bonds, and real estate. Some assets, like personal belongings and primary homes, are exempt under certain conditions.

Special Considerations for Couples and Homeowners

  • Protecting the Non-Applicant Spouse: Special rules are in place to prevent spousal impoverishment, like the Minimum Monthly Maintenance Needs Allowance (MMMNA).
  • Home Ownership Rules: The primary residence is generally exempt from Medicaid’s asset test, but there are certain conditions and equity limits to consider.

Strategies for Overcoming Financial Over-Limits

For seniors who find themselves financially over the limits, there are various strategies to still qualify for Medicaid. These include “spend down” programs or engaging in Medicaid planning with the help of professionals.

How to Apply for Medicaid in Nebraska

Applying for Medicaid in Nebraska is a straightforward process. Applicants can conveniently submit their application online through ACCESSNebraska. For those who prefer other methods, applications can be done by phone at 1-855-632-7633, or by mailing a completed paper application to the nearest Department of Health and Human Services (DHHS) office. Additionally, local Area Agencies on Aging offer support and assistance in the application process.

It’s crucial for applicants to ensure they meet all the eligibility criteria before applying. If there’s any uncertainty about meeting income or asset limits, engaging in Medicaid planning is advisable. The application process, especially for long-term care Medicaid, can be complex, so understanding the procedure and requirements in advance is beneficial.

Making Medicaid Understandable for Nebraska Seniors

Understanding Medicaid eligibility can be challenging, but with the right information and resources, navigating this system can be more manageable for Nebraska seniors and their families. Whether it’s exploring different program options, understanding financial criteria, or considering strategies for qualification, this guide serves as a starting point for those seeking Medicaid assistance in Nebraska.

Frequently Asked Questions about Medicaid in Nebraska

  1. What is the income limit for a single senior applying for Medicaid in Nebraska?
    • For 2023, a single senior applying for Medicaid must have an income under $1,215 per month.
  2. Can a non-applicant spouse’s income affect a Medicaid applicant’s eligibility?
    • In the case of Institutional Medicaid or Medicaid Waivers, only the applicant’s income is considered. However, for Regular Medicaid, the incomes of both spouses are combined for eligibility determination.
  3. Are there any assets exempt from Medicaid’s asset limit in Nebraska?
    • Yes, exemptions include personal belongings, an automobile, irrevocable burial trusts (up to certain limits), and usually the applicant’s primary home, subject to specific conditions.
  4. What should I do if my income or assets are over the Medicaid eligibility limits?
    • Individuals over the financial limits may still qualify through “spend down” programs or other Medicaid planning strategies. Consulting with a Medicaid planning advisor is recommended for tailored advice.
  5. How are home and community-based services different from nursing home Medicaid?
    • Home and Community-Based Services (HCBS) are designed to help seniors remain in their homes or community settings, delaying or avoiding nursing home placement. These services are limited and may have waiting lists, unlike nursing home Medicaid, which is an entitlement program.

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