Medical Assistance for Long-Term Care Services

2.4.2 Financial Eligibility

This subchapter describes financial eligibility policies that apply to Medical Assistance for Long-Term Care Services (MA-LTC).

Married people with an MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) basis of eligibility and married people with an MA for Families and Children with a Medical Spenddown basis of eligibility who are requesting MA-LTC may be required to complete an asset evaluation to determine if any of their spouse’s assets affect their asset limit.

People who have used benefits from a qualifying LTC Partnership (LTCP) insurance policy may have assets that do not count toward their asset limit and may be protected from estate recovery.

People who meet the eligibility requirements for MA-LTC may be obligated to contribute income toward the cost of the LTC services they receive. The amount of income that a person must contribute to the cost of LTC services is based on an LTC income calculation or a community income calculation. These calculations determine the amount of a person’s LTC spenddown, medical spenddown, or waiver obligation and depend on whether the person is receiving services through a Home and Community Based Services (HCBS) waiver or live in a long-term care facility (LTCF).

Topics covered in this subchapter are: