Medicaid for the Elderly, Blind or Disabled

Institutional Medicaid

Institutional Medicaid provides medical services for those who reside in a medical care facility such as skilled nursing facilities (SNF), intermediate care facilities (ICF), institutions for mental disease (IMD), and hospitals.

In order to receive Institutional Medicaid, your assets must be lower than the asset limit. The asset limit for one person is $2,000. The asset limit for married couples is described in the Spousal Impoverishment Section. The income limit is $2,130.

There are two ways to qualify for Institutional Medicaid. Your monthly gross income (job income and wages and other income) is first compared with the Level 1 Income Limit (see Income Test). If your gross income is less than the Level 1 Income Limit you may be able to enroll in Institutional Medicaid.

If your gross income is greater than the Level 1 Income Limit, your gross income is compared to the cost of your medical needs. If your gross income is less than your medical needs, you may be able to enroll in Institutional Medicaid.

Medical Need

The following expenses are used when determining your medical needs for Institutional Medicaid.

*This is the actual cost of the institutional care.

Institutional Medicaid Cost Share Calculation

There may be a monthly cost share for someone enrolled in Institutional Medicaid.

Cost Share

Depending on your income and marital status, you may have to pay toward your cost of care. This is called your cost share. Medicaid will pay for the rest of the Medicaid covered services.

Your cost share calculation will differ depending on your marital status and the Long-Term Care program you are enrolled in. (See the description and calculations for your specific Long-Term Care program in this handbook).

The cost share is calculated as follows:

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Last Revised: February 06, 2013