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Kokua Line June Watanabe |
Medicaid rules exempt
house, cars and ringQuestion: Regarding Medicaid: I read that on the mainland, you can have a $2 million house and so much money, and yet you can go on Medicaid. What is the difference between Hawaii and the mainland regarding qualifying for Medicaid?
Answer: Medicaid is a federal-state program set up to provide medical care to eligible needy persons. It is run by state or local governments within federal guidelines and varies from state to state.
As a general Medicaid rule, a family home -- no matter how valuable -- is an exempted asset, said Paul Higa, eligibility section supervisor, policy and program development, for the state's Med-QUEST Division.
There are both resource (assets) standards and income standards for Medicaid. A family home is exempted under the resource standard, Higa said.
Generally, to qualify, a single person cannot have more than $2,000 in assets, while a couple cannot have more than $3,000. You can also tack on an additional $250 for each additional person in the household.
In Hawaii the family home, any automobiles, household furnishings, one wedding ring and one engagement ring are exempted assets. Everything else -- stocks, bank accounts, IRAs, other real property, other jewelry, etc. -- are counted, Higa said.
So, yes, you can own a $2 million house and still possibly qualify for Medicaid. However, Higa said, if you are paying a mortgage on a $2 million house, you obviously have income that probably exceeds the income standard for Medicaid.
If you're over 65 or disabled the standard used in determining the qualifying income level for Medicaid is 100 percent of the poverty level for Hawaii, Higa said.
For Hawaii, for 2003, that currently is $861 a month for a single person, $1,162 for a couple, plus $301 for each additional individual in a family.
However, while you may be disqualified for having just $1 above the maximum asset level, you may qualify for partial Medicaid even if your income exceeds the maximum level, Higa said.
For example, you're a single person earning $1,000 a month, which exceeds the $861 income limit, but have "huge medical bills." Your assets are under $2,000. If your medical bill amounts to $1,000 a month, you may qualify for partial aid because the bill in one month exceeds the difference between income and $418 ($1,000 - $418 = $582).
If the services are covered by Medicaid, Medicaid may then pay for the amount over $582.
Higa also explained that assets are considered as of the first of each month. If you do not meet the standard then, you're ineligible for the rest of the month. However, you may reapply the next month.
Hawaii's Medicaid program separated into two parts in 1994. Generally, individuals 65 and over, or certified blind or disabled, are covered under a Fee-for-Service program, where providers are paid directly. All other individuals are covered under a managed-care program called Hawaii QUEST.
For more information, call 586-5390; for applications, call 587-3879.
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