Assets and Medicaid question...

[mitch777]

After being turned down three times for SSDI I need some help here regarding how assets can affect being eligible for Medicaid.

I'm just trying to understand my worst case scenario if my re-arguement and/or final appeal fails. I am unable to work after being POZ for almost 33 years so getting a job is out of the question.

There is the distinct possibility that I will be moving to Palm Springs on my own with no income until I turn 62. (SS kicks in, but that alone might bump my income slightly above the limit)

I did some limited research (tedious) and it seems that assets don't count although income derived from my investments would?

If that is true do I need to have an uninvested stack of cash to live off of to avoid going above the 133% Medicaid eligibility level (slightly above 15k)? In other words do I have to avoid stock sale profits beyond that level?

I know I could not afford even a ACA policy, even with the subsidies, as the max out of pocket would break the bank in no time.

My isolation needs to end while I still have enough gusto to have a social life while trying to preserve enough assets to at least get me to 70.

Just trying to nail down my future healthcare costs.

Any help would be appreciated.

[JR Gabbard]

Hi Mitch--

The only assets that do not count toward the total assets cap for SSI (other than the house you own and live in, and your primary vehicle if you use it for transport to medical appointments) are assets that are held in special-needs trusts.  Those are complicated to properly draft, and you'll need to hire a good attorney who specializes in special-needs trusts and public benefits to protect yourself.  It may or may not be a viable option for you.  I suspect it would require a radical restructuring of your asset profile.
A special-needs trust is one where the trustor (you) has no access to the trust funds, and the trustee can only use income from the trust to pay for your necessities of life (housing and healthcare, namely).

[mitch777]

Thanks JR.

I wasn't thinking along the lines of SSI. Basically I was wondering if I applied for Medicaid due to low income would my assets disqualify me from eligibility?

[JR Gabbard]

Medicaid and SSI use the same eligibility rules.  Mostly.

[helpfuler]

Edited: Sorry, misread the original post.

[helpfuler]

My understanding is that certain assets, possibly depending on state, even if considered not countable or excluded (or no asset test) in terms of an asset, do count towards income. So for example "ongoing business concerns" may be an excluded asset in some states but may count toward income if it is generating it. It is best to either speak with a benefits/entitlements counselor familiar with Medi-Cal or perhaps lawyer depending on your asset/income situation. You can also call Medicaid in California (Medi-Cal) or call a Certified Enrollment Counselor and ask eligibility questions. The rules for Medicaid eligibility in many states have changed within the past year or 2 so I think you are best off going directly to the source for information.

Palm Springs is in Riverside County.

Here is the medi-cal website for riverside:

http://dpss.co.riverside.ca.us/

Some contact info

http://www.coveredca.com/medi-cal/

You may be able to plug in some numbers here without creating an account to see eligibility:

https://www.mybenefitscalwin.org/web/consortium/home;jsessionid=E8D9B9D27AEBD03AE5367AB450AE099D.worker2?p_p_id=welcome_WAR_calwinportlet&p_p_lifecycle=0&p_p_state=normal&p_p_mode=view&p_p_col_id=column-1&p_p_col_count=1&_welcome_WAR_calwinportlet_action=amIEligibleAnonymous


Income limits for Medi-Cal:

http://www.dhcs.ca.gov/services/medi-cal/Pages/DoYouQualifyForMedi-Cal.aspx

[helpfuler]

You may want to call them (Medi-Cal, or a Certified Enrollment Counselor) and ask about both scenarios: SSDI (disabled) Medi-Cal and Low Income Medi-Cal and eligibility rules for both as far as assets/income goes so this way you have the info in advance and can plan.

[Jeff G]

Hi Help ... Welcome to the forums. Please introduce yourself, are you HIV positive ?

[helpfuler]

Hi Jeff G. Thank you. I'm not HIV positive. I just was reading a couple of these threads and thought I would offer some info as I have some exp with this though not in Cal.

One other thing:

SSI and Medicaid generally do no use the same eligibility rules.

While SSI grants the recipient Medicaid automatically in most if not all states, the rules for SSI are very strict in terms of assets and income. They are usually the strictest of all categories.

In NYC for example, there is no asset test for non disabled/blind, there is a around 14k asset test for disabled (SSDI) with medicare and SSI recipients cannot have more than 2k in assets. The income levels may be slightly different.

[Jeff G]

Hi Jeff G. Thank you. I'm not HIV positive. I just was reading a couple of these threads and thought I would offer some info as I have some exp with this though not in Cal.

One other thing:

SSI and Medicaid generally do no use the same eligibility rules.

While SSI grants the recipient Medicaid automatically in most if not all states, the rules for SSI are very strict in terms of assets and income. They are usually the strictest of all categories.

In NYC for example, where there is no asset test for non disabled/age 65+ or blind, a around 14k asset test for disabled with medicare and SSI recipients cannot have more than 2k in assets.

SSI is even different than having SSDI and being disabled in that the allowed assets are usually higher. In NYC for example, being disabled (through SSDI) allows 14k in assets. Being disabled and having SSI allows only 2k.

With the exception of the someone I care about has HIV forum ( if it applies to you ) as a person not living with HIV you are not allowed to post in the forums. The forums are intended for people living with HIV.

[helpfuler]

Ok.. sorry about that.