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 individuals eligible for SSI, who are automatically eligible for Medicaid with no separate application.

    • Group B includes individuals with incomes up to100 percent of the Federal Poverty Level, which is $749 in 2003. No cost sharing is required.

    • Group C includes medically needy individuals who must spend down to $242, the amount they may keep to pay for community living expenses such as housing, food, and transportation. Any expenditure that the IRS considers to be a medical expenditure for purposes of tax deductions can be counted as a medical expense

  • Asset limits for both groups are $2000 for an individual and $3000 for a couple.

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