The Basics of the Medicaid Asset or Resource Rules:
How Much Can I Have, and What can I do if I am Over the Medicaid Limits?

Medicaid Asset or Resource Rules:

In order to be eligible for Medicaid benefits a nursing home resident may have no more than $2,000 in "countable" assets (the figure may be somewhat higher in some states). The spouse of a nursing home resident--called the "community spouse" -- is allowed to keep the couple's assets of up to $113,640 (in 2012) in "countable" assets in Georgia. This is called the Community Spouse Resource Allowance, or "CSRA." This figure is lower in some states, such as South Carolina.

All assets are counted against these limits unless the assets fall within the short list of "noncountable" assets. These include the following:

    • Personal possessions, such as clothing, furniture, and jewelryOne motor vehicle is excluded, regardless of value, as long as it is used for transportation of the applicant or a household member.
    • The applicant's principal residence, provided it is in the same state in which the individual is applying for coverage (the states vary in whether the Medicaid applicant must prove a reasonable likelihood of being able to return home). Under the Deficit Reduction Act of 2005 (DRA), principal residences may be deemed non-countable only to the extent their equity is less than $525,000, with the states having the option of raising this limit to $786,000 (in 2012). In all states and under the DRA, the house may be kept with no equity limit if the Medicaid applicant's spouse or another dependent relative lives there.
    • Prepaid funeral plans and a small amount of life insurance
    • Certain Retirement funds, such as IRAs, 401(k)'s, 403(b)'s, and other qualified funds are treated differently depending on who owns them, but may be excluded:
      • Owned by the Medicaid applicant: Countable, unless in "payout status," which means if the retirement fund is paying out the Required Minimum Distribution or "RMD" on an equal monthly basis, the payout is income but the "principal" of what is inside the retirement fund does not count against the Resource Limit. 
      • Owned by the Community Spouse at Home: The retirement fund of the spouse at home is always exempt, whether in payout status or not.
      • Assets that are considered "inaccessible" for one reason or another

Your Home:

In Georgia, nursing home residents do not have to sell their homes in order to qualify for Medicaid. But as noted above, under the DRA principal residences may be deemed non-countable only to the extent their equity is less than $525,000, with the states having the option of raising this limit to $786,000. In all states and under the DRA, the house may be kept with no equity limit if the Medicaid applicant's spouse or another dependent relative lives there. However, we must be educated on the Estate Recovery Program, which allows the state to come back against the home for every dollar spent under the Medicaid program. So while the home doesn't count against you, we should have a discussion about steps to take to protect the home from Estate Recovery. More can be found on Estate Recovery on the page dedicated to that discussion topic.

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