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A common concern among seniors is Medicaid eligibility for long-term care services. Seniors face the daunting prospect of exhausting their savings to cover nursing home expenses. With limited coverage from Medicare and traditional health insurance, Medicaid often becomes the only viable option for our aging residents.
What is Wisconsin Medicaid?
Wisconsin Medicaid is a joint federal and state healthcare program designed to assist eligible Wisconsin residents aged 65 and above with limited resources who require long-term care.
What factors determine Medicaid eligibility?
One determining factor for eligibility involves income. For single Medicaid applicants, the monthly income threshold in 2022 was approximately $2,523.
In the case of married couples, the income limit for the “community spouse,” also known as the “well” spouse, should not exceed $3,715.50 or $3,051.66 plus any excess shelter allowance, whichever is less. Notably, a monthly personal needs allowance of $45.00 is not counted as income.
Assets are also considered when determining eligibility. Medicaid applicants must possess $2,000 or less in cash and nonexempt assets. However, the community spouse is typically allowed to retain up to half of the couple’s countable assets, capped at $148,620.
Certain assets, such as the primary home, automobile, household furnishings, clothing, life insurance policies with a cash value below $1,500, and an irrevocable burial trust worth up to $1,500, are considered exempt.
Wisconsin Medicaid follows a “five-year look-back” rule, which entails scrutinizing any gifts or transfers made by seniors eligible for Medicaid within the five years preceding their application. Such transfers may lead to a disqualification period for Medicaid benefits. However, Wisconsin Medicaid rules offer asset-protection opportunities for both proactive long-term care planning and immediate care needs.
How does this affect me?
Staying informed about Medicaid eligibility requirements is essential for individuals and their loved ones who anticipate or require long-term care. If you or a loved one needs long-term care, it may be worthwhile to explore the available asset-protection options.
When you contact our Milwaukee area law firm, your case will be treated like a unique request for assistance.