What is the Medicaid spend down rule in Montana?
Asked by: Robin Parker | Last update: August 10, 2025Score: 4.6/5 (17 votes)
What is the asset limit for Medicaid in Montana?
Individuals may be eligible for Medicaid if determined blind or disabled using Social Security criteria, and if their income is within allowable limits and their resources do not exceed $2000 for an individual or $3000 for a couple.
Does Medicaid care about your assets?
Some states, like New York and Illinois, allow you to keep significantly more assets, and other states, like Connecticut, less. California is the only state that doesn't have an asset limit for Medicaid, starting in 2024.
What is the look back period for Medicaid in Montana?
LOOK-BACK PERIOD:
The look-back period begins the date an institutionalized or HCBS/Waiver individual (married or single) requests Medicaid coverage. The look-back period is 60 months for all transfers, including trust payments to or for the benefit of a person or entity other than the Medicaid client.
What happens if you make too much money while on Medicaid?
If you're over the Medicaid income limit, some states let you spend down extra income or place it in a trust to help you qualify for Medicaid. If you receive long-term care but your spouse doesn't, Medicaid will allow your spouse to keep enough income to avoid living in poverty.
Medicaid Spend Down- How does it work?
How does a spend down work with Medicaid?
During the “look back”, all past transfers are reviewed. If one has gifted assets or sold them under fair market value during this timeframe, a Penalty Period of Medicaid ineligibility will be established. California has no asset limit (eff. 1/1/24), and therefore, Asset Spend Down is not relevant for this state.
What is the spend down rule for Medicaid in Montana?
Qualifying When Over the Limits
Examples include paying for private health insurance and medical care not covered by Medicaid. The amount one must “spend down” is the difference between one's monthly income and MT's medically needy income limit (MNIL).
How do I protect my assets from Medicaid look back?
By transferring your assets into an irrevocable trust, you effectively remove them from your ownership, thereby protecting them from Medicaid's asset requirements. However, it's important to note that once assets are transferred to an irrevocable trust, you no longer have control over them.
What is the income limit for Medicaid in Montana in 2024?
Yes, Montana's Medicaid expansion took effect in January 2016, after CMS approved Montana's Medicaid expansion waiver in late 2015. Under the expanded guidelines, Medicaid is available for all adults with incomes up to 138% of poverty; in 2024, that's $20,782 for a single adult.
How often does Medicaid check your bank account?
Medicaid agencies can check your account balances for bank accounts at any financial institution you've used in the past five years. They will check when you submit an application and on an annual basis, but checks can occur at any time.
How much money does Medicare allow you to have in the bank?
This means individuals can have any amount of assets and still qualify for a Medicare Savings Program. Assets are things that you own, such as bank accounts, cash, second homes and vehicles.
What is the highest income to qualify for Medicaid 2024?
Parents of Dependent Children: Income limits for 2024 are reported as a percentage of the federal poverty level (FPL). The 2024 FPL for a family of three is $25,820. Other Adults: Eligibility limits for other adults are presented as a percentage of the 2024 FPL for an individual is $15,060.
What is an exempt asset for Medicaid?
There are “countable assets” and “exempt assets”. An applicant's home furnishings and appliances, personal items, vehicle, and generally their home, are exempt. For home exemption, an applicant (or their spouse) must live in their home or the applicant must have “Intent to Return”.
How does Medicaid know your assets?
Required documentation to be provided by the applicant might include checking, savings, money market, credit union, and certificates of deposit (CD) account statements, life insurance policies, deeds or appraisals for one's home and other real estate, copies of stocks and bonds, deeds to burial plots, and copies of pre ...
How do I check my Medicaid status in Montana?
You can check the status of an application through your account on the state's application website: www.apply.mt.gov. Your healthcare provider or pharmacy may also be able to look you up to see if you are approved for Medicaid.
What is the Medicaid five year rule?
In most states, the Look-Back Period is five years long. This means the state officials who are reviewing your Medicaid application will “look back” into your financial history for the five years before you applied to make sure you haven't given away any money or assets, or sold them at less than fair market value.
Do nursing homes take your assets?
Neither the nursing home nor the government will seize your home to cover expenses while you are living in care. However, if you run out of funds to pay for the care you need, your estate's assets may be taken after your death to cover those costs.
What assets are exempt from Medicaid in Montana?
Exempt Assets for 2025 for an Applicant in Montana:
One home with an equity limit of $688,000 (exempt if planning to return, or if a spouse, child under 21, or disabled dependent resides there). One car. Prepaid funeral plans up to $1,500 or irrevocable burial contracts.
What qualifies for spend down?
These people may qualify for Medicaid if they spend the excess income on medical expenses. This is called a spend down. If you meet all the other requirements for Medicaid but your income is higher than the Medicaid limit, you may be placed on a spend down. Spend down works like an insurance policy deductible.
How can I reduce my Medicaid spending?
We chose 5 areas of savings applicable to Medicaid: (1) modification of physician payment models to reduce unnecessary care, (2) development of a medication adherence program for patients dually eligible for Medicaid and Medicare support (“dual eligibles”), (3) improvement in unnecessary admissions and readmissions for ...
What happens if you win money while on Medicaid?
Winning the lottery generally doesn't require you to pay back Medicaid costs. However, it can affect your eligibility for Medicaid, as eligibility often depends on income levels, which vary by state. You might lose your benefits if your lottery winnings push your income above the Medicaid threshold.
What is the spend down rule for Social Security?
For SSI and Medicaid, the term “spend down” refers to spending excess money down to the applicable resource limit (which is generally $2,000 for an unmarried individual and $3,000 for a married couple). The spend down must occur in the same month in which the money is received.
How much money do you spend on Medicaid?
Other states with significant year-over-year spending increases included Washington ($4.1 billion), Illinois ($2.8 billion), and California ($2.4 billion).