Medicaid for nursing home and home care in Mississippi

Who qualifies

You must:

• Be 65 or older, or blind or disabled.
• Live in Mississippi and be a U.S. citizen or qualified immigrant.
• Have a doctor certify that you need nursing home care, either in a facility or through a home care waiver.
• Apply for other benefits you may be owed, such as VA, retirement or disability benefits.
• Be within the income and asset limits below.

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The income rule and the Income Trust

Mississippi has a firm income limit for long-term care. If your total monthly income is over $2,982, you can still qualify by setting up an Income Trust (also called a qualified income trust or Miller trust).

• How it works: Your income goes into a special trust account. Money from the trust goes toward your care. When the trust ends, including at your death, what is left goes to the Division of Medicaid, up to what Medicaid paid for you.
• Who can use it: People in a nursing home (not in a hospital for acute care) and people in a home care waiver. In a waiver, income over the limit is paid each month to the Division of Medicaid.
• The ceiling: If your income is more than the nursing home's private pay rate, a trust will not help, and you cannot qualify this way.
• Only income goes in. You cannot put savings or property into this trust.
• Get legal help. The Division of Medicaid has a trust form and help sheet, and its Legal Unit answers questions from lawyers drafting a trust at 601-359-6050.

If your income is above 135% of the federal poverty level, Medicaid in a medical facility also requires a stay of at least 31 days in a row.

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What counts and what does not

Countable assets include money and property you own alone or with someone else. The limit for one person is $4,000.

These are not counted:

• Your home, unless your equity is over $752,000.
• One car.
• Household goods, and other personal property up to $5,000.
• Life insurance: cash value of whole life policies, if the face values of all policies on you add up to $10,000 or less. Term life is not counted.
• Burial: burial spaces for family members, and up to $6,000 set aside for burial.
• Income-producing property that earns at least 6% of its equity each year, if you actually get the income.

Gifts and transfers. Medicaid looks back five years. If you gave away assets or sold them for less than they were worth, there may be a penalty. In a nursing home, Medicaid will not pay the facility during the penalty. In a waiver, you will not be eligible during the penalty.

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What you pay and what you keep

In a nursing home, most of your income goes to the facility each month. This is called your Medicaid Income. Before that is figured, these are taken out:

• Your personal needs allowance of $44 a month ($90 for a veteran or surviving spouse with a VA pension).
• An allowance for a spouse at home, and for other dependent family.
• Your health insurance premiums.
• Some medical costs Medicaid does not cover.

People in home care waivers do not pay Medicaid Income, unless they have an Income Trust.

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If your spouse lives at home

• Assets: Your spouse can keep up to $162,660 of your combined countable assets, plus things that are not counted. The spouse who needs care can keep up to $4,000. If assets must be moved into your spouse's name, you have 90 days after you are told.
• Income: Your spouse can get up to $4,066.50 a month, minus their own income, from the income of the spouse in care.
• Waivers: For home care waivers, these spouse rules apply only if you live together.
• Free assessment: If one spouse is in long-term care, you can ask Medicaid to review your assets before applying.

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Home care waivers

• Elderly and Disabled Waiver: For people 21 and over who would need a nursing home without help. A nurse and social worker plan your care. It can pay for personal care, adult day services, extended home health, home-delivered meals, in-home and facility respite, minor home safety repairs, medication reviews by a pharmacist, and help moving home from a nursing home. Your need for care is checked at least every 12 months.
• Assisted Living Waiver: For people 21 and over who need nursing home care but live in a licensed personal care home that takes Medicaid. Medicaid pays for care. You pay room and board.

We did not find a PACE program on Mississippi Medicaid's pages. Ask the MAC Center what is available near you.

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How to apply

1. Call the MAC Center at 844-822-4MAC (4622) for a waiver. A full long-term care assessment decides if you need this level of care, and they help you choose services. For a nursing home, your stay must be certified as medically necessary.
2. Send the Medicaid application. Apply online at access.ms.gov, or mail the Application for Aged, Blind and Disabled Individuals to the Division of Medicaid, P.O. Box 2222, Jackson, MS 39225, or fax it to 601-576-4164. You can also apply at any of the 30 Medicaid Regional Offices. Call 800-421-2408 to find yours.
3. Ask about past months. Medicaid can cover up to three months before the month you apply if you qualified then.
4. Wait for a decision. The rule is 45 days, or 90 days if Medicaid must first decide whether you are disabled.

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After you apply

• Renewals: Your case is reviewed at least every 12 months. You get at least 30 days to return a renewal form.
• Report changes within 10 days.
• Appeals: Ask for a hearing within 30 days of the date the notice was mailed, in writing, by telling a Medicaid specialist, or in person at a Regional Office. To keep benefits during the appeal, ask within 10 days. After a local hearing, you have 15 days to ask for a state hearing.
• Estate recovery: After death, Medicaid may seek repayment from the estate of a person 55 or older who was in a nursing home or waiver, but not if there is a surviving spouse, a dependent or disabled child in the home, or undue hardship.

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Things people miss

• Check that the nursing home or provider takes Medicaid before you get care.
• An Income Trust can open the door if your income is just over the limit.

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Free help

• MS Access to Care (MAC) Center and SHIP: 844-822-4622.
• Division of Medicaid, Office of Long Term Care: 800-421-2408 or 601-359-6141.
• Area Agencies on Aging: find yours at mdhs.ms.gov/aging.

See also paying for a nursing home, Medicare, and all benefits in Mississippi.

Phone numbers: Free help lines for Mississippi agencies

Check what you may qualify for