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FREQUENTLY ASKED QUESTIONS (FAQ)

Q: Can my disabled spouse receive Medicaid at home?

A: Yes, the resource rules for couples are the same for the Home and Community Based Services (HCBS) program covering in home care and assisted living as the nursing home program. The program for inhome care is also available for single people.

Q: What is the community spouse resource allowance for 2010?

A: $109,560.00. The resource allowance for the Medicaid recipient is $2,000.00.

Q: What is the average monthly nursing home cost in the state of Colorado for 2010?

A: $6,267. 

Q: If my spouse is on Medicaid, what is the minimum monthly maintenance needs allowance for me?

A: $1,821.25 (figure may adjust on July 1, 2010). The Monthly Maintenance Needs Allowance is the amount the community spouse is entitled to each month as determined by the Department of Human Services. It includes the spouse’s own income and an allocation from the income of the Medicaid recipient spouse. Remember that the community spouse is entitled to all of his/her own income.

 Q: If my spouse is on Medicaid, what is the maximum monthly maintenance needs allowance for me?

A: $2,739.00 (effective through December 31, 2010). It is possible to receive a higher allowance through the administrative review process.

Q: Will I have to give my property to the state in order to be eligible for Medicaid?

A: No. The state does not take your property. However, the Medicaid program has resource rules applied equally to everyone. You will have to use/spend down your assets in order to qualify for Medicaid if you have more resources than the program allows.

Q: Will I have to sell my home?

A: If you are married, the non-Medicaid spouse always has the right to the home. The rules are complicated when married couples are involved and you should talk to an attorney before you make any decisions about the home.

If you are a single person, while you are alive you may keep your residence, providing its value is less than $500,000. However, after you die the state has the right to claim reimbursement for the amount of Medicaid paid on your behalf. There are some exceptions to this rule. Again, the rules regarding residences are complex and you will want to discuss your plans with an attorney before you apply for Medicaid.

Q: If I give money away will I be penalized (ineligible for Medicaid)?

A: For transfers (gifts) made on or after February 8, 2006, the look back period is 60 months prior to the date of application. For transfers (gifts) made before February 8, 2006 the look back period is 36 months prior to the date of application (60 months for trusts).

In order to determine the months of ineligibility for Medicaid, the value of the gift is divided by the average monthly nursing home cost in the state of Colorado at the time of application. The result is the number of months of ineligibility.

Prior to February 8, 2006, the ineligibility period for gifts began to run when the gifts were made. After February 8, 2006, the ineligibility period does not begin to run until after the applicant is eligible for and applies for Medicaid and would be approved but for the imposition of the penalty period (or it has been more than 60 months).

An approved application requires that the applicant meet the level of care (medical) requirements and the income and resource guidelines.  There are some planning tools for gifting but you will need the assistance of an attorney.   For additional details read the regulations at 8.100.7.G . 

Q. How does Medicaid treat personal care services provided by family members?

A.  Effective March 1, 2007, payments to family members for personal services (running errands, bill paying, etc.) will be deemed to be a gift unless there is a written agreement prior to delivery of services.  The written agreement must meet specific guidelines and payments may not be made to a family member who is also the agent under a power of attorney.

 Q.  Do the rules regarding Medicaid change frequently?

 A.  Yes, the rules change frequently, so you should seek legal advice before making decisions.

 
To view Medicaid regulations online:

1) Go to:  www.sos.state.co.us/CCR/Welcome.do

2) On the Code of Colorado Regulations page, click on the link labeled Browse the CCR by Rule Number.

3) On the Code of Colorado Regulations Department List page, scroll to 2505 (the bottom of the list) and click on Department of Health Care and Financing.

4) On the Code of Colorado Regulations Agency List page, click on 2505 Medical Services Board.

5) On the Code of Colorado Regulations Titles page, click on the fourth link down, 10 CCR 2505-10 8.100 Medical Assistance - Section 8.100.

6) On the Code of Colorado Regulations Subtitles page, click on the link labeled 8.100 Medical Assistance Eligibility.

7) The 8.100 Medical Assistance Eligibility page provides a menu on the left. Scroll down to 8.100.7 Long Term Assistance Eligibility.

At this point, you two options for accessing the long term eligibility rules:

1) Next to the option 8.100 7 Long Term Assistance Eligibility, you can click on the small box with a "+" sign, which reveals a clickable list of rules.

2) Or you can simply click on the label, 8.100 7 Long Term Assistance Eligibility, and then access all the rules via the main box on the right. (In the upper right of that box there are navigation links labeled "Previous" and "Next.")