May 22

Common Medicaid Terminology


Medicaid 101

Medicaid can be very complex. It has a language of its own. Here is an explanation of some common Medicaid terminology:

  • Community Spouse – A married individual that does not need Medicaid assistance.
  • Institutionalized Spouse – Is the individual that needs the long-term care assistance whether it is in the home, in an assisted living facility, or in a nursing home.
  • Snapshot Date – The first day of a period of 30 continuous days in either a long-term care facility or a hospital or a combination of both. The snapshot date is used to determine the resources that a married couple can exempt during the Medicaid process.
  • Asset – Examples include: cash, other liquid assets, vehicles, real property, business interests, retirement accounts, annuity contracts, life insurance policies, and any other property that can be converted into cash to pay for care. Medicaid has strict asset restrictions that must be met to qualify for eligibility. An individual or a community spouse will only be allowed to keep a limited amount of assets in their own name.
  • Income – Includes cash and other items of value that are available and attributable to the Medicaid applicant. Income includes both earned and unearned income and even items such as food and shelter. Common income sources are Social Security, pension income, and a VA benefit.
  • Share of Cost – The amount of the Medicaid applicant’s monthly income that must be contributed to the cost of their care.
  • Personal Needs Allowance (“PNA”) – The amount of the Medicaid applicant’s monthly income that the individual can keep and use in whatever manner they would like.
  • Monthly Income Allowance (“MIA”) – If the community spouse’s income does not meet the minimum standard, a community spouse may receive additional income from the institutionalized spouse in order to have enough income to maintain a household.
  • Qualified Income Trust (“QIT”) – A trust that may be needed for income qualification for Medicaid eligibility. A QIT is needed by a Medicaid applicant when their monthly gross income is above the special income limit set by the Medicaid rules. The income above the special income limit should be placed in the QIT and used for allowable expenses. A QIT has a Medicaid payback provision. A QIT is sometimes also referred to as a “Miller Trust”.
  • Improper Transfer – Is a transfer of assets in order to qualify for Medicaid. Improper transfers (also referred to as uncompensated transfers) can include transfers for love and consideration or transfers made below fair market value. Medicaid requires documentation from the applicant for the past five years to identify such improper transfers.

If you need assistance applying for Medicaid contact Butcher Elder Law today.