Using Medicaid to Cover Services for Elderly Persons in Residential Care Settings: State Policy Maker and Stakeholder Views in Six States. Financial Criteria

12/01/2003

  • hree groups are financially eligible for nursing home services:

    • Group A includes persons with incomes no higher than the Federal poverty level (FPL), of $749. Individuals receiving federal Supplemental Security Income benefits (SSI) or state supplement payments (SSP), or who have incomes no higher than the combined SSI/SSP level ($552 + $81 = $633) are automatically included in this group.

    • Group B includes persons with incomes up to the special income standard of 300 percent of SSI ($1,656).

    • Group C includes medically needy individuals who spend down to 75 percent of the FPL. There is no upper limit on income, but income can be no greater than $562 after deducting medical expenses.2 The applicant may choose a 1 month or 6 month budget period for determining medical need.

  • Asset limits for all three groups are $3,000 for an individual and $6,000 for a couple.3

  • The monthly personal needs allowance for nursing home residents is $72. The Minnesota Supplemental Aid program, which is the state's SSP program, will pay a maximum of $42 to supplement the federal SSI $30 PNA for individuals who are no longer eligible to receive SSI because they are residing in an institution.


  1. The State applies the following §1902(r)(2) less restrictive resource methodologies for Group C: household/personal goods are excluded and a more liberal homestead exclusion is allowed for certain long term care residents.

  2. Asset limits for the Minnesota Supplemental Aid program are lower, i.e., $2,000 for an individual and $3,000 for a couple.

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