FINANCIAL ELIGIBILITY: Divided into income and asset categories, different for married and unmarried persons.

INDIVIDUAL NEEDING NURSING HOME CARE

INCOME:  Income of the person in the nursing home (the "institutionalized person") must be less than the total cost of care, plus applicant's regular monthly medical expenses not paid by insurance or any other source and certain other allowances, including a "personal needs allowance" of $40 per month.  The remainder goes to the nursing home and health insurance premiums unless it is needed for spouse at home (see below).

ASSETS:  Can keep $2,500 ($3,000 if both spouses need nursing home care).  Count all cash, savings, investments (mutual funds, stocks, bonds, etc.), cash value of life insurance policies with a face value above $1,500, retirement plans, real property. In addition, recipient is allowed to retain $1,500 in a revocable burial trust, or any amount (with no maximum) in an irrevocable burial trust. Also not counted: certain annuities, a burial space, and personal effects.  Any excess assets must be "spent down" before institutionalized person becomes eligible for Medicaid.

SPOUSES AT HOME

INCOME: The spouse at home (the "community spouse") can keep all of his or her own income (i.e. a pension). The community spouse can receive additional income from the income of the institutionalized spouse to bring community spouse's income up to $1,383 per month (assuming that much income exists between husband and wife). An additional amount is awarded to the community spouse if shelter costs (rent, mortgage, taxes, insurance, utilities, maintenance fee for a condominium) exceed $415. The community spouse's income allocation from the institutionalized spouse can't exceed $2,049 per month.

ASSETS: Some assets are not counted or divided, and may be retained by the community spouse, such as the family home, one vehicle, certain annuities, burial trusts, burial spaces, and personal effects. Other "countable" assets, such as those listed at the top of the page, are divided equally between spouses regardless of which spouse's name assets are in. The community spouse may keep his or her one-half of the assets, subject to the limits below.  The community spouse can't be awarded less than $16,824 (if the couple had that much), so if his or her one-half of the assets is less than this amount, assets are transferred from the institutionalized spouse to increase the community spouse's resources. The community spouse can't keep more than $84,120. Excess assets of the institutionalized spouse and the community spouse are "spent down."

EXAMPLES:  Example #1: $20,000 total assets -The spouse at home can keep $16,824 and the nursing home spouse must spend $676 to reach the $2,500 qualifying level. Example #2: $180,000 total assets - community spouse at home received $84,120 and the nursing home spouse must spend $93,380 to reach the $2,500 qualifying level. Example #3: $120,000 total assets - Each spouse receives $60,000, and nursing home spouse must spend $57,500.