Federal law, specifically 42 U.S. Code § 1396p(c)(2)(D), dictates that a state must establish procedures that allow a Medicaid applicant to receive needed care via a hardship waiver. In these cases, the applicant (or their spouse) had made a transfer during the look-back period that would otherwise incur a penalty whereas the applicant would not be eligible to receive Medicaid benefits for a certain period of time. If the applicant can show that the imposition of the penalty period would deprive the applicant of necessary medical care or the necessities of life, then the hardship waiver can be approved, allowing the applicant to get needed care immediately. Basically, the penalty period is waived if the hardship waiver is granted.

What happens if a Medicaid applicant has funds in a bank account but cannot access those funds due to their medical condition? Are those funds still a countable resource? This issue was recently litigated in Indiana.

Samuel was admitted to the nursing home in 2019. A few months thereafter, he was diagnosed as “incapacitated by senile degeneration of the brain.” In February 2020, Samuel’s representative applied for Medicaid benefits and was denied due to excess assets. Samuel twice appealed and the case was affirmed each time.

Last August, we published a blog about California’s new Medicaid eligibility rules. Well, those new rules are coming to fruition and will drastically change Medicaid planning in that state.

Most states have a $2,000 asset limit for an individual to qualify for Medicaid. California was no exception. However, the new rules change the asset limit for an individual to $130,000 ($267,000 for a married applicant) as of July 1, 2022. Even more astonishing – all resources will be disregarded no sooner than January 1, 2024. Meaning, a MAGI-based applicant can have unlimited resources and qualify for long-term care Medicaid at that time.