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


  • Three groups are financially eligible for waiver services:

    • Group A includes persons with incomes no higher than the Federal poverty level (FPL), which is $749. Individuals receiving SSI/SSP benefits, 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).6

    • 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.7 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.8

  1. The 300 percent of SSI rule is for the aged only. CRS Report for Congress, Medicaid: Eligibility for the Aged and Disabled, updated July 5, 2002.

  2. 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.

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

View full report


"med4rcs.pdf" (pdf, 3.73Mb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®