Medicaid For Elderly, Blind and Disabled Adults
State of Connecticut
Department of Social Services
Questions and Answers
What is Medicaid?
Medicaid (also called Title 19) is a health care program operated by the State of Connecticut Department of Social Services. Medicaid covers most medical expenses, including doctor visits, inpatient and outpatient hospitalization, lab and x-ray, durable medical equipment, home health care, vision and dental care, long term care (nursing home care) and prescription drugs.
Who is Eligible for Medicaid?
Persons age 65 and over, disabled persons between 18 – 65, and persons who are legally blind may qualify for Medicaid. The applicant must be a Connecticut resident and a US citizen or an eligible non-citizen.
Is there an Asset Limit?
Yes. The asset limit for a single person is $1600. The asset limit for a married couple is $2400. Not all assets are counted against this limit. For example, home property is excluded. Life insurance is excluded if the face value of all policies owned by the applicant is less than $1500. One motor vehicle is excluded in most cases. An applicant can exclude up to $5400 in an irrevocable burial fund.
What if an Applicant has Excess Assets?
There is no eligibility for Medicaid in any month where countable assets exceed the asset limit.
What if an Applicant or Recipient Transfers Assets?
Individuals requesting long-term care or home care services may have a period of ineligibility if they transfer an asset for less than fair market value in order to qualify for Medicaid. This period of ineligibility is called a "transfer of assets penalty period." The department only looks at transfers made during a specified "lookback" period (36 or 60 months, depending on the type of asset transferred). Some transfers are exempt from transfer of asset rules. The most common examples of exempt transfers are transfers to a spouse or disabled child.
6. Is there an Income Limit?
Yes. For persons living in the community, the income limits are:
Region A Regions B & C (most of Connecticut)
Individual $574.86 $476.19
Couple $733.59 $633.49
7. Are there any Income Deductions?
Yes. Not all income is counted against the income limit. For example:
Earned Income: If you are working, we do not count the first $65 ($85 for blind persons) plus ½ of the remainder of monthly income.
NOTE – Please see question 9 if you are disabled and working.
Unearned Income: We also disregard a portion of unearned income, such as Social Security and pensions. The monthly disregards are:
For a person living in the community - $183
Sharing a home with a non-relative - $250.90
Living in a licensed boarding home - $90.70
8. What if my income is over the income limit?
Under our "spenddown" policy, you may qualify even if your income is over the income limit. The spenddown process uses medical bills as income deductions. Once your medical bills equal the amount of your excess income (income that is over our income limit), you may qualify for benefits. Bills paid by insurance cannot be deducted from income, with the exception of medical bills paid by the ConnPACE* program on your behalf. Under spenddown, eligibility is recalculated every six months.
* ConnPACE is a state program that helps seniors and disabled persons to pay for certain prescription drugs, insulin and insulin syringes. Participants pay only $12 for each prescription and ConnPACE pays the rest.
What if I am disabled and working?
DSS administers a special program called "Medicaid for the Employed Disabled (MED)." Under this program, an eligible person under age 65 with a disabling condition can qualify for Medicaid without the use of spenddown. Participants can earn up to $75,000 per year; gross income may be reduced by deductions for employment related work expenses. Participants may also retain assets up to $10,000 ($15,000 for a couple); not all assets are counted against this limit. Persons with income over 200% of the Federal Poverty Level may have to pay a monthly premium for Medicaid coverage.
10. Are there other Medicaid programs that can help pay medical bills?
Yes. If you have or are eligible for Medicare Part A, our QMB program can pay all Medicare co-pays and deductibles up to the Medicaid rate for that service. The QMB income and asset limits are higher than for basic Medicaid. Effective January 2002, a single person may have income up to $922 per month ($1361 for a couple). The asset limit is $4000 for a single person ($6000 for a couple); not all assets are counted against this limit.
The QMB program also pays the Social Security Administration directly for your Part B Medicare premium, currently $54 per month. This means the amount of your Social Security check will increase every month.
Two other programs (SLMB and ALMB) also pay the Part B premiums. SLMB have higher income limits than QMB (up to 175% of the Federal Poverty Limit).
For more information about Medicaid,
you may call … 1-800-994-9422
Content Last Modified on 8/21/2007 2:16:27 PM