Understanding Medicaid Eligibility for Seniors in Indiana

Medicaid plays a pivotal role in ensuring that low-income families receive the care they need to maintain their health and well-being. Medicaid also serves as a crucial lifeline for many seniors in Indiana, providing access to essential healthcare services they might not otherwise be able to afford. For many seniors, that includes paying for nursing home care. To benefit from the Medicaid program, however, you must first be found eligible. With that in mind, an Indianapolis Medicaid planning attorney at Frank & Kraft discusses Medicaid eligibility for seniors in Indiana.

Why Do I Need to Worry about Medicaid Eligibility?

Medicaid is a healthcare program that is predominantly funded by the federal government; however, it is administered at the state level. Consequently, eligibility criteria for Medicaid can vary from state to state. Understanding the eligibility requirements is essential for seniors seeking assistance with healthcare costs. It is also crucial for seniors planning for the likely need to qualify for Medicaid.

Before reaching retirement age, you may depend on employer-sponsored or privately purchased health insurance to cover medical bills. When you turn 65, you will likely be eligible for Medicare which will cover most of your healthcare expenses going forward. While you are young and healthy you may not think much about the potential need for long-term care when you are older. Statistically, however, you (and your spouse if you are married) stand about a 70 percent chance of needing some type of long-term care (LTC) services after you reach retirement age (65) – and those odds will only increase as you age. For 2023, the average cost of a year in LTC in Indiana was over $115,000. Imagine how fast you will go through your retirement savings if you must pay that cost out-of-pocket. To avoid losing your retirement nest egg, you need to be eligible for Medicaid because Medicaid does cover LTC expenses.

Indiana Senior Medicaid Eligibility Requirements

Because Medicaid is a “needs-based” program, eligibility for Medicaid will depend, in part, on the value of your countable resources and your monthly income. Specifically, Indiana Medicaid requirements for seniors include:

• Income Requirements: Medicaid eligibility in Indiana is primarily based on income, and seniors must meet specific financial criteria to qualify for benefits. For elderly individuals aged 65 and older, the income limit typically falls within a certain range set by the state. As of 2023, this threshold stands at $1255-$2829 per month (depending on the Medicaid category) for a single applicant. It’s important to note that this limit may change annually, so applicants should verify the most up-to-date figures.
• Asset Limits: In addition to income, Indiana Medicaid also considers an applicant’s assets when determining eligibility. Assets include cash, bank accounts, investments, real estate, and certain personal property. Certain assets may be exempt, however, from consideration, such as a primary residence (up to $713,000), household items, and a vehicle. As of 2024, the asset limit for a single applicant is $2,000 but, again, applicants should verify this figure with the most recent guidelines. Indiana uses a five-year look-back period that effectively prevents an applicant from transferring assets during the five-year period prior to applying for benefits in anticipation of the need to qualify for benefits. Medicaid planning can help you plan for eligibility while protecting your hard-earned assets.
• Long-Term Care Needs: For seniors requiring long-term care services, such as nursing home care or home health services, Medicaid eligibility criteria may differ. Indiana Medicaid offers assistance for long-term care services through various waiver programs, including the Aged and Disabled Medicaid Waiver and the Community Integration and Habilitation Medicaid Waiver. These programs provide support for seniors who wish to receive care in their homes or in community-based settings rather than in a nursing facility.