Medicaid is a federal public health insurance program created to provide health care to low income individuals, including people with disabilities. It also funds long term care services in Medicaid funded facilities, and home and community-based services through the Medicaid Waiver. To be eligible for Medicaid, a person with a disability must qualify for both disability and asset guidelines.
A person with a disability must have a physical or mental impairment, disease or loss that has lasted or appears reasonably certain to last for at least 12 months, or that will result in death.
To meet financial eligibility guidelines, a person's income must be below a specific maximum. As of January 1, 2008 the maximum for an individual is $637 a month, and the maximum for a person who is married, using combined income, is $956 a month.
Assets must also be below a specified maximum. Effective January 1, 2008 for an individual the maximum is $1,500. If the person is married, the maximum is $2,250 for the couple.
If a person has income and/or assets over these guidelines, he or she can receive Medicaid through what is called "spend-down."
Each month, to be eligible for Medicaid in that month, a person's medical expenses must equal his spend-down. Once medical expenses equal spend-down, then Medicaid coverage is available to that person for the remainder of the month. The spend-down amount is determined through a formula set by Medicaid.
Financial Eligibility and Indiana's Medicaid Waiver Program
Parental income and resources are not counted when determining Medicaid eligibility for children receiving services through a Medicaid waiver or in a Medicaid funded group home or nursing home. Any income or assets the child may have will be counted.
The Developmental Disabilities and Support Services Medicaid waivers also modify the income that a recipient can have and still be eligible for Medicaid. Effective January 1, 2008, the income limit for an individual is $1,911 a month.
What Health Services Does Medicaid Cover?
The following health related services are covered under Indiana's Medicaid program: