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Getting around Medicaid Income Caps

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    Medicaid Income Cap and Miller Trusts.. Why this exists or has to be so complicated is beyond me. But this is worth sharing and knowing, none-the-less..

    If you and/or your spouse is earning income (or SS benefits, any incoming income really) while receiving Medicaid and nursing home care, there is a cap to how much you can earn per month. It slightly varies from state to state, but in most cases all monies earned over the cap you do not get to keep, unless you 'spend down' OR open what's called a Miller Trust (or Qualified Income Trust). Here's an official explanation, per ElderLawAnswers (other sources site this info as well):

    What Is the Medicaid Income Cap?

    In order to qualify for Medicaid, a nursing home resident's income must not be above a certain level. Most states allow individuals to spend down their excess income on their care until they reach the state's income standard. But other states impose an "income cap," which means no spend-down is allowed.

    In "income cap" states, a nursing home resident won't be eligible for Medicaid if the resident's income exceeds $2,199 a month (for 2016), unless the excess income above this amount is paid into a special trust, called a "Miller" trust or a "Qualified Income Trust."

    The income cap states as of this writing are: Alabama, Alaska, Arizona, Arkansas, Colorado, Delaware, Florida, Georgia, Idaho, Indiana, Iowa, Kentucky, Louisiana, Mississippi, Nevada, New Mexico, New Jersey, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, and Wyoming.


    So to get Medicaid, you can't really earn much of any living, if you and/or your spouse wants assistance for nursing home care costs, which can be VERY expensive. This seems counter productive to me. Disincentiving seniors to make extra money, for fear of either not qualifying for certain programs, or just simply working and giving ALL of their earnings to the government over a low cap? I fail to understand the logic here.

    Anyone enlighten me? Or does this seem unfair to you as well? Anyone here having to deal with this income cap nonesense?

    Another good resource for this issue: How Income Trusts Help If Your Income Is Too High for Medicaid

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    My grandparents are doing this dance right now. My grandmother is in the late stages of parkinsons. For a long time, they could only afford to keep her at home with a nurse who visited every day. The nurse was paid out of pocket by my family. Since her last stint in the hospital, she is in a nursing home. The money from Medicaid is limited to only 20 days. If it wasn't for the kindness of the nursing home by letting them pay what they can, she would be sent back home.
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    JFoster Wrote: My grandparents are doing this dance right now. My grandmother is in the late stages of parkinsons. For a long time, they could only afford to keep her at home with a nurse who visited every day. The nurse was paid out of pocket by my family. Since her last stint in the hospital, she is in a nursing home. The money from Medicaid is limited to only 20 days. If it wasn't for the kindness of the nursing home by letting them pay what they can, she would be sent back home.
    Is that 20 days every month, or just 20 days period?
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    With the assistance of my attorney I prepared and submitted a Miller Trust and have received notification that it was accepted by Florida Medicaid. My question is, WHAT'S NEXT??? My disability income is $201 above the limit. Is Medicaid supposed to direct deposit the "overage" (they made me send them proof of the Trust account that was set up).