However, for Medicaid eligibility, there are many assets that are not counted, as they are considered exempt. This spousal impoverishment rule is intended to ensure the non-applicant spouse has sufficient funds with which to live. On June 30, 2020, the Oklahoma Medicaid Expansion Initiative, State Question 802, passed by a majority vote to expand Medicaid eligibility to adults ages 19-64 whose income is 138% (133% with a 5% disregard) of the federal poverty level or lower. 2020 Pregnant Women: Full Scope Benefits & SoonerPlan Family Size Monthly Income Annual Income 1 $1,416 $16,992 2 $1,912 $22,944 3 $2,408 $28,896 4 $2,905 $34,860 5 $3,401 $40,812 6 $3,897 $46,764 7 $4,395 $52,740 8 $4,891 $58,692 *In addition to income, there are different eligibility requirements & benefit packages available. 2020 SLMB income & resource limits: Individuals: monthly income limit:* $1,296 (up from $1,269 in 2019) resource limit: $7,860 (up from $7,730 in 2019) Married couples: monthly income limit:* $1,744 (up from $1,711 in 2019) resource limit: $11,800 (up from $11,600 in 2019) *Limits are slightly higher in Alaska and Hawaii. �՗�пL#%FI9J. ��-J Self-employed persons must provide complete federal personal and business taxes. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. However, in 2012 the U.S. Supreme Court ruled expansion was optional for each state. QI income & resource limits in 2020: Individual monthly income limit* $1,456. The table below provides a quick reference to allow seniors to determine if they could be immediately eligible for long term care from an Oklahoma Medicaid program. Persons might also find their local Area Agency on Aging office helpful, as they should be able to answer Medicaid program questions and offer application assistance. 2) Medicaid Waivers / Home and Community Based Services (HCBS) – Limited number of participants due to enrollment caps. Medicaid is a health care insurance program, jointly funded by the state and federal government, for low-income individuals of all ages. Said differently, while the IRS allows US citizens to gift a specific amount of money tax free, this gifting is still a violation of Medicaid’s look back period. MedicaidPlanningAssistance.org is a free service provided by the American Council on Aging, What is the Medicaid Estate Recovery Program, Minimum Monthly Maintenance Needs Allowance, spending excess assets on non-countable assets, 2020 Oklahoma Medicaid Long Term Care Eligibility for Seniors, $2,000 for applicant & $128,640 for non-applicant, Medicaid Waivers / Home and Community Based Services, Regular Medicaid / Aged Blind and Disabled. 2 0 obj `�ǂSҐF�T2�Ůb��*!��^�d�(���gC�!e��R��\p+?��G6�g��c�8� БI���[흍8�s�:cE/����w�A��}���������'����_v��3�����#^?�{{��r���~���y���X{��-���\on�o~�������|�����O`����m��|��������c���n��o�+F/U��p�O���43�0&��e�m@۠[�ںٞ�����mp�Dm~�{�˭������pOMs �����B�u�B:�&�^`��}�� �F����[�����R���(]��a���;�9���P�� ��0z��������9^Z��4� �k�F��C�´��8�{̙�5 ��#7_o8�"�����p��oz�1�s^�޴� ��[9w�;$�����-�J� To apply for SoonerCare in Oklahoma, elderly individuals need to apply through the Department of Human Services. Copyright © 2021 All rights reserved. While there are many different eligibility groups, this page is focused specifically on Medicaid eligibility for senior Oklahoma residents (65 years of age and older). Not only is healthcare expensive, but not everyone has access to insurance that makes it more affordable. 2) Medicaid Planning – the majority of persons considering Medicaid are “over-income” or “over-asset” or both, but still cannot afford their cost of care. ���@U t�N[I�����I However, one can “spend down” assets by spending excess assets on non-countable assets. 3 0 obj Unfortunately, at this time, there is no option for seniors to apply for long-term care Medicaid online. The Oklahoma Health Care Authority on Friday submitted paperwork to expand Medicaid to adults ages 19-64 whose income does not exceed 133% of the federal poverty level, which is $16,970 annually for an individual and $34,846 for a family of four. Voters rejected State Question 814 this week. À�A�f��I�i�d��M��Nl}��E�F����H��wȏ)r��?u��O_\>����Ywqu�=}��t���s|ĝ��넒=��r��{���Cww|��3���M���||����7v����~>>�_\v]Q4OEC�� � ��z&T��=��yǭ��`�+�)�W�3��v|iz� F���>��g/}pd��g�G�7�������ߞ_mO���/��~��G����G׀��E,AQ��FP�e/��gU R��cz�;�m�m�Y�Y���?,�)o,;�����Lw��^� �w� L0�U�]~�����w����P/�o \���{H�w�X^.A $ 50,928 5. In simple terms, one’s excess income (over the Medicaid limit) is directly deposited into a trust, in which a trustee is named, giving that individual legal control of the money. 2016 Income/Rent Limits (effective 3/28/16). Another important point to make is that the IRS gift tax exemption does not extend to Medicaid eligibility. Prior to submitting a SoonerCare application, Oklahoma seniors need be certain that they meet all of the eligibility criteria, which are covered in detail above. By working with a Medicaid planning professional, families can employ a variety of strategies to help them become Medicaid eligible. Examples include paying for home modifications (wheelchair ramps, roll-in showers, pedestal sinks, and stair lifts), vehicle modifications (wheelchair lifts, adaptive control devices, and floor modifications to allow one to drive from a wheelchair), prepaying funeral and burial expenses, and paying off debt. If your income is higher than $2,349 a month, you cannot qualify for Medicaid even after spending down all assets, unless you set up a Miller trust. Assistance is provided at home, adult day care, or in assisted living. In Oklahoma, Medicaid is called SoonerCare and is administered by the Oklahoma Department of Human Services (OKDHS). This site is for information purposes; it is not a substitute for professional legal advice. For 2020, the income limit for an individual is $2,349 and the asset [resource] amount is $2,000. 1) Institutional / Nursing Home Medicaid – is an entitlement (anyone who is eligible will receive assistance) program. (For Oklahoma Medicaid purposes, a Miller Trust is often called a Medicaid Income Pension Trust.) $ 33,468 3. 2) Personal Care Program – Part of Oklahoma’s state Medicaid plan, there is no waitlist to receive personal care assistance. Now voters have given the state legislature an assignment: Find another way to pay for it. Participants in this program have the option of letting the state manage the care services they receive or self-directing their own care. �e�c�N���S�=V k�ۚ�&x J��[�@c` 7+�̸2WFC?3?J���#�0��+G�[C0SK.CZ14 ��ȭH���r�a�,G�D�`�4%�%�E���#Rv�&H��g{��������V%��� g�˂�H�e�" I���UT�Df3�����+|oHg��v=O��tE�:��0&E*��D� ݶdA�#khej�}`z҂l�J��܂d���F0B����F�1̔� endobj �� The account must be irreversible, meaning once it has been established, it cannot be changed or canceled, and upon the passing of the Medicaid participant, the remaining funds must be paid to the state of Oklahoma. For persons in this situation, Medicaid planning exists. In addition, the application process can be lengthy and challenging, as documentation must be included with the application. Monthly maintenance standards are the amount of money the client may retain for his or her own needs. In fact, a portion (or all) of the applicant spouse’s income can be transferred to the non-applicant spouse. %PDF-1.5 <> Tax Credit Income & Rent Limits. To qualify, these individuals must meet income and other eligibility requirements. MAGI is used to determine financial eligibility for Medicaid, CHIP, and premium tax credits and cost sharing reductions available through the health insurance marketplace. The Affordable Care Act established a new methodology for determining income eligibility for Medicaid, which is based on Modified Adjusted Gross Income (MAGI). There are no income limits to ... but you retired in 2020 and are now only making $65,000 from benefits, you could appeal your IRMAA. 1) ADvantage Program Waiver – This Medicaid program allows program participants to direct their own care and even hire some family members to provide personal care assistance. Oklahoma is pushing forward a Medicaid plan that would charge premiums and impose employment requirements on low-income heath insurance recipients. Since Oklahoma did not accept the Affordable Care Act expansion for Medicaid, the state does not recognize low-income adults without children as eligible applicants. The Affordable Care Act was signed into law in March 2010. �*�K�,$b�Y[�U�~Y��{45���_&�̽�e�H��%�2��>��0�Q��(G�1%L4^vٌ] Ȭ�o�� Unfortunately, Income Only Trusts do not assist one in qualifying for Medicaid if they are over the asset limit. One should be aware that Oklahoma has a Medicaid Look-Back Period, which is a period of 60 months that dates back from one’s Medicaid application date. 2015 Income/Rent Limits (effective 03/06/15). $ 2,060 $ 24,720. If you are married, then your spouse can also have income and resources that are protected. As of 2020, the income cap for a QIT is $5,420 / month. This equates to an estimated annual income of $16,970 for an individual or $34,846 for a family of four. 2017 Income/Rent Limits (effective 4/14/17). For Oklahoma elderly residents (65 and over), who do not meet the eligibility requirements in the table above, there are other ways to qualify for Medicaid. No limit, but income over $1,157 / month must be paid towards one’s cost of … It’s important to note, this even includes gifts or transfers a non-applicant spouse has made. By using our website, you agree to our terms of use and privacy policy. 2019 Income/Rent Limits (effective 4/24/19). Further complicating eligibility are the facts that the criteria vary with marital status and that Oklahoma offers multiple pathways towards eligibility. Assistance with ADLs includes helping an eligible applicant dress, use the bathroom, eat, and so forth. Self-dir… For married couples, as of 2020, the community spouse (the non-applicant spouse) of a nursing home Medicaid applicant or Medicaid waiver applicant can keep as much as 50% of the couple’s joint assets, up to $128,64. stream Learn more on how Medicaid counts income. Children are now covered up to 205% of federal poverty level (FPL) The income limits for children to be enrolled on Soonercare are: Household Size Income Limit 2 $33,648 3 $42,336 4 $51,036 5 $59,724 6 $68,424 The Oklahoma Personal Care program provides disabled and elderly residents with the funds to retain a personal care assistant to help them manage their Activities of Daily Living(ADLs) in their home or a family members home. Unfortunately, violating the look-back period is cause for penalty in the form of Medicaid ineligibility for a period of time. Assistance is provided only in nursing homes. $ 4,973 $ 59,676. That said, the focal point will be on long term care, whether that be at home, in a nursing home, or in an assisted living facility. This type of trust allows seniors who are over the Medicaid income limit to still qualify for long-term care Medicaid, as money deposited into a QIT does not count towards Medicaid’s income limit. For example, FY 2020 Income Limits are calculated using 2013-2017 5-year American Community Survey (ACS) data, and one-year 2017 data where possible. <>/PageLabels 306 0 R>> Provide any requested proof of income, such as taxes, pay-stubs and W-2s. (You can't get QI benefits if you qualify for Medicaid). 2020 Income/Rent Limits (effective 4/01/20). Back in June, Oklahoma voted to expand Medicaid. All of an individual's monthly income must go towards their cost of care, which can include medical bills, prescriptions and other health care costs, aside from $50 which is for a personal needs allowance. 2. Eligibility overview: Every adult between the ages of 19 and 64 with income up to 133% of the FPL may be eligible for Medicaid. To find your local county office, click here. April 22, 2020 - Oklahoma is the first state to officially request a Healthy Adult Opportunity demonstration waiver to expand its Medicaid program using the new block grant system. Therefore, wait lists may exist. Monthly Income limits for Medicaid Programs. 2013 Income/Rent Limits (effective 12/04/12) These programs have slightly different financial and medical eligibility requirements, as well as varying benefits. This is a Medicaid program that is also referred to by the name of State Plan Personal Care (SPPC). Assistance is provided at home or adult day care. In addition, the money in the account can only be used for very specific purposes, such as paying long term care services / medical expenses accrued by the Medicaid enrollee. <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> }z���q�gڔ������au�H��i�������rjk�{FO �+���\���/9��/��~�~�� As passed, it guaranteed health care to low income citizens through expansion of Medicaid. Medicaid Income Limits for 2020 To qualify for Medicaid through SSI the income limit for an aged, blind or disabled individual cannot exceed $803 per month or $1.195 for a c ouple. x��\[oܸ~7�����bf+�_ endobj IMPORTANT, not meeting all the criteria below does not mean one is not eligible or cannot become eligible for Medicaid in Oklahoma. �(e��$�D�\�}Ia �QdmyW� &Q��E�1L���W���6Of�gU�&QJ>EI5����\v6�/q������7�3sڈg��ve�:��6f��Ǟ���1�0����c#��ϡ��H�(����3�̰���B This, in Medicaid speak, is referred to as the Community Spouse Resource Allowance (CSRA). If you have income from working, you may qualify for benefits even if your income is higher than the limits listed. That said, the focal point will be on long term care, whether that be at home, in a nursing home, or in an assisted living facility. JUL 23, 2020 - The Stitt administration is moving forward with plans to expand Medicaid to cover more low-income Oklahomans on July 1. �Ti#�(m��"�\�Z�MH7$��C:*DKl4޳Y��Z���ڛ޺Z+������� >��%`��[I�������a�dsE2�j�]E��Al�0�1�jf� ZR�[�+��C�R0����-�|h��i?ay�}��7[���}'��~��J����SX��{7p��ӧ���[�{�7��bw�{�_���nL0��v? Common Types of Social Security Benefits The Social Security Administration (SSA) manages various benefits programs that pay cash allotments to […] Medicaid is a state/federal program that pays for medical services for low-income pregnant women, children, individuals who are elderly or have a disability, parents and women with breast or cervical cancer. By Associated Press , … (This figure is shown in the chart above). Countable assets include cash, stocks, bonds, investments, credit union, savings, and checking accounts, and second homes, such as vacation homes. This resource allowance does not extend to non-applicant spouses of those who are applying for regular Medicaid. �����V'��1>Ѯ�U��P�̑��XWO8�CDZ�L:��X���A��.Ot�)� For an individual the resources cannot exceed $2,000 per month or $3,000 per month for a couple. �9��CJ�%��c Petitioners should know what are the income requirements for Medicaid eligibility based on their household size since the number of family members influences the income limits. Although HUD uses the most recent data available concerning local area incomes, there is still a lag between when the data are collected and when the data are available for use. endobj Although the state’s SoonerCare Medicaid coverage is available for Oklahoma children with household incomes as high as 205 percent of poverty, parents with dependent children are only eligible for Medicaid if their annual household income is under 41 percent of poverty (just over $10,000 for a family of four), and most childless adults are ineligible regardless of income. Exemptions include personal belongings, household furnishings, an automobile, irrevocable burial trusts, and one’s primary home, given the Medicaid applicant or his or her spouse lives in the home and the home equity value is not greater than $585,000 (in 2019). Effective 3/1/2020 $ 3,515 $ 42,180. 1) Qualified Income Trusts (QIT’s) – QIT’s, also referred to as Miller Trusts, are for Medicaid applicants who are over the income limit, but still cannot afford to pay for their long-term care. �3Y��zsr(�@�2mw� ��ݫ��7���Ӽ��|,�8X�ֽ�SP������n�v��) �t�|��S�P�`�w�38,��S��c���=3�U�u�����]ŸdLÇR���qϴ:;����3usf᫂$�I5��g This equates to an estimated annual income of $16,970 for an individual or $34,846 for a family of four. For Medicaid eligibility purposes, any income that a Medicaid applicant receives is counted. <> Monthly countable income must be equal to or less than the Categorically Needy Standard of $2,205 (300% of Federal Benefit Rate). Said another way, if one meets the income requirements for Medicaid eligibility, but not the asset requirement, the above option cannot assist one in reducing their extra assets. Read more or connect with a Medicaid planner. A variety of other benefits are available, including adult day care, personal emergency response systems, home modifications, and respite care. Oklahoma is an “income first” state, meaning the state limits the right to petition for an increased community spouse resource amount (CSRA) to couples whose combined income fails to meet the community spouse’s income needs. 1. 2020 Program Limits by Family Size . The maximum amount of income the Medicaid office allows a community spouse to keep in Oklahoma is $3,090. Persons who have excess income and / or assets, should strongly consider Medicaid planning. The complicated picture of Medicaid expansion in Oklahoma is beginning to clear as a result of actions taken by the Legislature last week. ���nQD�+B:�!��D��XB�:> There are several different Medicaid long-term care programs for which Oklahoma seniors may be eligible. 2 $ 2,789. Said another way, the income of the non-applicant spouse is disregarded. To be clear, this income can come from any source, such as employment wages, alimony payments, pension payments, Social Security Disability Income, Social Security Income, IRA withdrawals, and stock dividends. Alternatively, persons may take the Medicaid Eligibility Test. Married couple monthly income limit* $1,960 *Limits are slightly higher in Alaska and Hawaii. As of 2020, up to $3,216 / month can be transferred to the non-applicant spouse from his/her applicant spouse. This Oklahoma Medicaid waiver is designed to help frail elders remain living in their homes, or the home of a family member, instead of in a nursing home environment. … More. Annual Income. While there are many different eligibility groups, this page is focused specifically on Medicaid eligibility for senior Oklahoma residents (65 years of age and older). 2018 Income/Rent Limits (effective 4/1/18). Medicaid Income Limits by State 2020 Many residents would say that one of the biggest problems in the United States is the state of healthcare. For general information about the application process for long-term care Medicaid, click here. Some examples ofresources are: 4 $ 4,244. When only one spouse of a married couple is applying for nursing home Medicaid or a HCBS Medicaid waiver, only the income of the applicant is counted. %���� If half of the assets are less than $25,728, the non-applicant spouse can keep 100% of the assets, up to $25,728. On June 30, 2020, the Oklahoma Medicaid Expansion Initiative, State Question 802, passed by a majority vote to expand Medicaid eligibility to adults ages 19-64 whose income is 138% (133% with a 5% disregard) of the federal poverty level or lower. 4 0 obj Medicaid is a health care insurance program, jointly funded by the state and federal government, for low-income individuals of all ages. Maximum monthly countable income for a Medicaid Income Pensions Trust cannot exceed $4,422. This, in Medicaid terminology, is called a Minimum Monthly Maintenance Needs Allowance (MMMNA), and is the minimum amount of monthly income to which the non-applicant spouse is entitled. The maximum amount of income that can be retained is $3,216.00. Applying for Medicaid services involves an evaluation of your income and assets. In addition, resource limits apply. 2014 Income/Rent Limits (effective 12/18/13). Seniors participating in the ADvantage Program can access a variety of long term care services, such as personal care and assistance, home modifications for increased safety and access, and adult day care. This program allows for self-direction, meaning the program participant is able to hire, train, and manage the personal care assistant of their choosing. For the eligibility groups reflected in the table, an individual’s income, computed using the Modified Adjusted Gross Income (MAGI)-based income rules described in 42 CFR 435.603, is compared to the income standards identified in this table to determine if they are income eligible for Medicaid or CHIP. These limits are determined by each state, but federal policy establishes what types of income and assets are counted or exempt for retirees. During this time frame, Medicaid checks to ensure no assets were sold or given away under fair market value. Medicaid in OK expanded June 1, 2016. 1 0 obj This program is based on the Medicaid Cash and Counseling model, in which th… (This is not true for a married couple with one spouse applying for Regular Medicaid). 3) Regular Medicaid / Aged Blind and Disabled – is an entitlement (persons meeting eligibility automatically receive benefits) program. 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A variety of other benefits are available, including adult day care is administered by the of! Due to enrollment caps low income citizens through expansion of Medicaid law in March 2010 no option seniors.