What is Medicaid in Illinois?
Medicaid is a federal and state program that provides health care in Illinois. This article will
discuss Medicaid for patients in a long-term care facility. This is an overview of a very
Who Qualifies for Medicaid in Illinois?
The basic eligibility requirements are that the applicant must be a U.S. citizen (or non-citizen in
certain categories), an Illinois resident, 65 or older or disabled and must reside in a facility that
take Medicaid patients.
What are the asset limitations for Medicaid in Illinois?
- Single person asset limit: $2,000.00
- Couple asset limit: $3,000.00
- Spousal impoverishment limit: $109,560.00
Some assets are exempt and will not count in the above limits. The home is exempt if occupied
by the person as their home or if they intend to return to their home (usually within 120 days).
The home is also exempt if any of the following reside in the home:
- the person's spouse;
- a dependent sibling of the person;
- the person's child under age 21; or
- the person's adult child who is blind or has a disability;
- the person's son or daughter who provided care to the person and resided in the home for the
two years immediately before the person moved to the LTC facility.
Other exempt assets include:
- a vehicle with a value not exceeding than $4,500.00,
- cash value of life insurance $1,500.00 or less,
- term policies with no cash value, group policies provide by an employer.
Money for a funeral is also exempt in the following situations:
- Up to $1,500 of money set aside in a bank account or in a revocable prepaid burial
- Up to $6,680.00 in an irrevocable prepaid funeral contract.
- Prepaid burial contract funded by a life insurance policy when ownership of the insurance
policy has been irrevocably assigned.
Also exempt are:
Vaults, headstones, markets, plaques, burial containers, cost of opening and closing of the grave.
What about income limitations?
A single person’s monthly income must be less than the cost of the long-term care facility to
qualify for Medicaid.
Under the spousal impoverishment rules, the spouse at home is allowed to keep $2,739.00
income per month.
What is spousal impoverishment?
Spousal impoverishment assures that the spouse who is still living at home has enough assets and
income to pay for his or her expenses at home. The rules help prevent the spouse at home from
being impoverished when paying for long-term care expenses for the spouse in the facility.
Can’t I just transfer the assets to someone else and go on Medicaid?
Making transfers is not a good idea unless you know the consequences. Some transfers affect
eligibility, and some do not. Whether eligibility is affected depends on when the transfer took
place, the type of transfer and the reason for the transfer. Transfers that do not affect eligibility
are called allowable transfers.
Which transfers are allowable?
The following are allowable transfers:
- Transfers made more than 60 months before the date of the Medicaid application;
- Transfers for fair market value, such as a sale of a home;
- Transfers to a community spouse – the spouse still living at home;
- Transfers to the person's child of any age (who is blind or has a disability), or to another
person for the sole benefit of the person's child (who is blind or has a disability), or to a
trust created solely for the benefit of the person's child (who is blind or has a disability);
- Charitable gifts and gifts to family members which are consistent with amounts and
frequency of such gifts in the past;
- Transfers made exclusively for a reason other than to qualify for benefits.
- Transfers to special needs trust and pooled trusts in certain circumstances.
A transfer of the home is allowable to the following:
- the person's spouse; or
- the person's child under age 21; or
- the person's child of any age who is blind or has a disability;
- the person's brother or sister who has an equity interest in the homestead property and
who was living in the home for at least one year immediately before the date the person
entered the LTC facility;
- the person's child who provided care (either nursing or support) for the person and who
was living in the property for at least two years immediately before the date the
person entered the LTC facility;
One size does not fit all.
Medicaid rules can vary from state to state. There are different exceptions to the rules, especially
when there is a spouse, so it is wise to check with an elder law attorney about your specific
situation and how the Medicaid rules would apply to your situation.
Eileen R. Fitzgerald, Attorney at Law, 1561 Warren Ave., Downers Grove, IL 60515;